Method for controlling an energy module output

ABSTRACT

A method for controlling an output of an energy module of a modular energy system. The energy module can comprise a plurality of amplifiers configured to generate a drive signal at a frequency range and a plurality of ports coupled to the plurality of amplifiers. The method includes determining to which port of the plurality of ports the surgical instrument is connected, selectively coupling an amplifier of the plurality of amplifiers to the port of the plurality of ports to which the surgical instrument is connected, and controlling the amplifier to deliver the drive signal for driving the energy modality to the surgical instrument through the port.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims priority under 35 U.S.C. § 120 to U.S.patent application Ser. No. 16/562,135, titled METHOD FOR CONTROLLING ANENERGY MODULE OUTPUT, filed Sep. 5, 2019, now U.S. Patent ApplicationPublication No. 2020/0078076, the disclosure of which is hereinincorporated by reference in its entirety.

U.S. patent application Ser. No. 16/562,135 claims priority under 35U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No.62/826,584, titled MODULAR SURGICAL PLATFORM ELECTRICAL ARCHITECTURE,filed Mar. 29, 2019, the disclosure of which is herein incorporated byreference in its entirety.

U.S. patent application Ser. No. 16/562,135 claims priority under 35U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No.62/826,587, titled MODULAR ENERGY SYSTEM CONNECTIVITY, filed Mar. 29,2019, the disclosure of which is herein incorporated by reference in itsentirety.

U.S. patent application Ser. No. 16/562,135 claims priority under 35U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No.62/826,588, titled MODULAR ENERGY SYSTEM INSTRUMENT COMMUNICATIONTECHNIQUES, filed Mar. 29, 2019, the disclosure of which is hereinincorporated by reference in its entirety.

U.S. patent application Ser. No. 16/562,135 claims priority under 35U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No.62/826,592, titled MODULAR ENERGY DELIVERY SYSTEM, filed Mar. 29, 2019,the disclosure of which is herein incorporated by reference in itsentirety.

U.S. patent application Ser. No. 16/562,135 claims priority under 35U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No.62/728,480, titled MODULAR ENERGY SYSTEM AND USER INTERFACE, filed Sep.7, 2018, the disclosure of which is herein incorporated by reference inits entirety.

BACKGROUND

The present disclosure relates to various surgical systems, includingmodular electrosurgical and/or ultrasonic surgical systems. Operatingrooms (ORs) are in need of streamlined capital solutions because ORs area tangled web of cords, devices, and people due to the number ofdifferent devices that are needed to complete each surgical procedure.This is a reality of every OR in every market throughout the globe.Capital equipment is a major offender in creating clutter within ORsbecause most capital equipment performs one task or job, and each typeof capital equipment requires unique techniques or methods to use andhas a unique user interface. Accordingly, there are unmet consumer needsfor capital equipment and other surgical technology to be consolidatedin order to decrease the equipment footprint within the OR, streamlinethe equipment's interfaces, and improve surgical staff efficiency duringa surgical procedure by reducing the number of devices that surgicalstaff members need to interact with.

SUMMARY

In one general aspect, a method for controlling an output of an energymodule of a modular energy system. The energy module can comprise aplurality of amplifiers and a plurality of ports coupled to theplurality of amplifiers. Each of the plurality of amplifiers can beconfigured to generate a drive signal at a frequency range. Each of theplurality of ports can be configured to drive an energy modality for asurgical instrument connected thereto according to each drive signal.The method can comprise: determining to which port of the plurality ofports the surgical instrument is connected; selectively coupling anamplifier of the plurality of amplifiers to the port of the plurality ofports to which the surgical instrument is connected; and controlling theamplifier to deliver the drive signal for driving the energy modality tothe surgical instrument through the port.

In another general aspect, a method for controlling an output of anenergy module of a modular energy system. The energy module can comprisea plurality of amplifiers, a plurality of ports coupled to the pluralityof amplifiers, and a relay assembly, each of the plurality of amplifiersconfigured to generate a drive signal at a frequency range, each of theplurality of ports configured to drive an energy modality for a surgicalinstrument connected thereto according to each drive signal, the methodcomprising: controlling a first amplifier of the plurality of amplifiersto deliver a first drive signal to the surgical instrument connected toa port; controlling the relay assembly to couple a second amplifier ofthe plurality of amplifiers to the port; and controlling the secondamplifier to deliver a second drive signal to the surgical instrumentconnected to the port.

FIGURES

The various aspects described herein, both as to organization andmethods of operation, together with further objects and advantagesthereof, may best be understood by reference to the followingdescription, taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is a block diagram of a computer-implemented interactive surgicalsystem, in accordance with at least one aspect of the presentdisclosure.

FIG. 2 is a surgical system being used to perform a surgical procedurein an operating room, in accordance with at least one aspect of thepresent disclosure.

FIG. 3 is a surgical hub paired with a visualization system, a roboticsystem, and an intelligent instrument, in accordance with at least oneaspect of the present disclosure.

FIG. 4 is a partial perspective view of a surgical hub enclosure, and ofa combo generator module slidably receivable in a drawer of the surgicalhub enclosure, in accordance with at least one aspect of the presentdisclosure.

FIG. 5 is a perspective view of a combo generator module with bipolar,ultrasonic, and monopolar contacts and a smoke evacuation component, inaccordance with at least one aspect of the present disclosure.

FIG. 6 illustrates individual power bus attachments for a plurality oflateral docking ports of a lateral modular housing configured to receivea plurality of modules, in accordance with at least one aspect of thepresent disclosure.

FIG. 7 illustrates a vertical modular housing configured to receive aplurality of modules, in accordance with at least one aspect of thepresent disclosure.

FIG. 8 illustrates a surgical data network comprising a modularcommunication hub configured to connect modular devices located in oneor more operating theaters of a healthcare facility, or any room in ahealthcare facility specially equipped for surgical operations, to thecloud, in accordance with at least one aspect of the present disclosure.

FIG. 9 illustrates a computer-implemented interactive surgical system,in accordance with at least one aspect of the present disclosure.

FIG. 10 illustrates a surgical hub comprising a plurality of modulescoupled to the modular control tower, in accordance with at least oneaspect of the present disclosure.

FIG. 11 illustrates one aspect of a Universal Serial Bus (USB) networkhub device, in accordance with at least one aspect of the presentdisclosure.

FIG. 12 illustrates a logic diagram of a control system of a surgicalinstrument or tool, in accordance with at least one aspect of thepresent disclosure.

FIG. 13 illustrates a control circuit configured to control aspects ofthe surgical instrument or tool, in accordance with at least one aspectof the present disclosure.

FIG. 14 illustrates a combinational logic circuit configured to controlaspects of the surgical instrument or tool, in accordance with at leastone aspect of the present disclosure.

FIG. 15 illustrates a sequential logic circuit configured to controlaspects of the surgical instrument or tool, in accordance with at leastone aspect of the present disclosure.

FIG. 16 illustrates a surgical instrument or tool comprising a pluralityof motors which can be activated to perform various functions, inaccordance with at least one aspect of the present disclosure.

FIG. 17 is a schematic diagram of a robotic surgical instrumentconfigured to operate a surgical tool described herein, in accordancewith at least one aspect of the present disclosure.

FIG. 18 illustrates a block diagram of a surgical instrument programmedto control the distal translation of a displacement member, inaccordance with at least one aspect of the present disclosure.

FIG. 19 is a schematic diagram of a surgical instrument configured tocontrol various functions, in accordance with at least one aspect of thepresent disclosure.

FIG. 20 is a system configured to execute adaptive ultrasonic bladecontrol algorithms in a surgical data network comprising a modularcommunication hub, in accordance with at least one aspect of the presentdisclosure.

FIG. 21 illustrates an example of a generator, in accordance with atleast one aspect of the present disclosure.

FIG. 22 is a surgical system comprising a generator and various surgicalinstruments usable therewith, in accordance with at least one aspect ofthe present disclosure.

FIG. 23 is a diagram of a situationally aware surgical system, inaccordance with at least one aspect of the present disclosure.

FIG. 24 is a diagram of various modules and other components that arecombinable to customize modular energy systems, in accordance with atleast one aspect of the present disclosure.

FIG. 25A is a first illustrative modular energy system configurationincluding a header module and a display screen that renders a graphicaluser interface (GUI) for relaying information regarding modulesconnected to the header module, in accordance with at least one aspectof the present disclosure.

FIG. 25B is the modular energy system shown in FIG. 25A mounted to acart, in accordance with at least one aspect of the present disclosure.

FIG. 26A is a second illustrative modular energy system configurationincluding a header module, a display screen, an energy module, and anexpanded energy module connected together and mounted to a cart, inaccordance with at least one aspect of the present disclosure.

FIG. 26B is a third illustrative modular energy system configurationthat is similar to the second configuration shown in FIG. 25A, exceptthat the header module lacks a display screen, in accordance with atleast one aspect of the present disclosure.

FIG. 27 is a fourth illustrative modular energy system configurationincluding a header module, a display screen, an energy module, aeexpanded energy module, and a technology module connected together andmounted to a cart, in accordance with at least one aspect of the presentdisclosure.

FIG. 28 is a fifth illustrative modular energy system configurationincluding a header module, a display screen, an energy module, anexpanded energy module, a technology module, and a visualization moduleconnected together and mounted to a cart, in accordance with at leastone aspect of the present disclosure.

FIG. 29 is a diagram of a modular energy system including communicablyconnectable surgical platforms, in accordance with at least one aspectof the present disclosure.

FIG. 30 is a perspective view of a header module of a modular energysystem including a user interface, in accordance with at least oneaspect of the present disclosure.

FIG. 31 is a block diagram of a stand-alone hub configuration of amodular energy system, in accordance with at least one aspect of thepresent disclosure.

FIG. 32 is a block diagram of a hub configuration of a modular energysystem integrated with a surgical control system, in accordance with atleast one aspect of the present disclosure.

FIG. 33 is a block diagram of a user interface module coupled to acommunications module of a modular energy system, in accordance with atleast one aspect of the present disclosure.

FIG. 34 is a block diagram of an energy module of a modular energysystem, in accordance with at least one aspect of the presentdisclosure.

FIGS. 35A and 35B illustrate a block diagram of an energy module coupledto a header module of a modular energy system, in accordance with atleast one aspect of the present disclosure.

FIGS. 36A and 36B illustrate a block diagram of a header/user interface(UI) module of a modular energy system for a hub, such as the headermodule depicted in FIG. 33 , in accordance with at least one aspect ofthe present disclosure.

FIG. 37 is a block diagram of an energy module for a hub, such as theenergy module depicted in FIGS. 31-36B, in accordance with at least oneaspect of the present disclosure.

FIG. 38 is a block diagram of an energy module circuit, in accordancewith at least one aspect of the present disclosure.

FIG. 39 is a diagram of an energy module circuit, in accordance with atleast one aspect of the present disclosure.

FIG. 40 is a diagram of a leakage current detector circuit, inaccordance with at least one aspect of the present disclosure.

FIG. 41 is a logic flow diagram of a process for monitoring an energymodule circuit for monopolar leakage current, in accordance with atleast one aspect of the present disclosure.

FIG. 42 is a view of an electrical connector port configured to delivermultiple energy modalities, in accordance with at least one aspect ofthe present disclosure.

FIG. 43 is a block diagram of a surgical system, in accordance with atleast one aspect of the present disclosure.

FIG. 44 is perspective view of a modular energy system, in accordancewith at least one aspect of the present disclosure.

FIG. 45A is a bottom perspective view of a module of the modular energysystem of FIG. 44 .

FIG. 45B is a close-up of the module of FIG. 45A.

FIG. 46 is a top perspective view of a module of the modular energysystem of FIG. 44 .

FIG. 47 is a cross-sectional view of an upper module seated onto a lowermodule of a modular energy system, in accordance with at least oneaspect of the present disclosure.

FIG. 48A illustrates an upper module and a lower module of a modularenergy system in an assembled configuration, in accordance with at leastone aspect of the present disclosure.

FIG. 48B illustrates a post/socket configuration for connecting an uppermodule and a lower module of a modular energy system, in accordance withat least one aspect of the present disclosure.

FIG. 49 illustrates a male bridge connector portion comprising agrounding feature of a modular surgical module, in accordance with atleast one aspect of the present disclosure.

FIG. 50 is a cross-sectional view of an upper module seated onto a lowermodule of a modular energy system, in accordance with at least oneaspect of the present disclosure.

FIG. 51 illustrates a modular energy system, in accordance with at leastone aspect of the present disclosure.

FIG. 52 illustrates various electrical connections in the modular energysystem of FIG. 51 .

FIG. 53 illustrates a module of the modular energy system of FIG. 51 .

FIG. 54 illustrates a module of a modular energy system, which includesa rigid wire harness, in accordance with at least one aspect of thepresent disclosure.

FIG. 55 is a perspective view of a male bridge connector of a modularenergy system, in accordance with at least one aspect of the presentdisclosure.

FIG. 56 is a cross-sectional view of the male bridge connector of FIG.55 .

FIG. 57 is a perspective view of male and female bridge connectors of amodular energy system in an assembled configuration, in accordance withat least one aspect of the present disclosure.

FIG. 58 illustrates a modular energy system, in accordance with at leastone aspect of the present disclosure.

FIG. 59 illustrates various electrical connections in the modular energysystem of FIG. 58 .

FIG. 60 illustrates a modular energy system, in accordance with at leastone aspect of the present disclosure.

FIG. 61 illustrates a side view of the modular energy system of FIG. 60.

FIG. 62 illustrates a modular energy system comprising a latch, inaccordance with at least one aspect of the present disclosure.

FIG. 63A illustrates a modular energy system comprising a latchassembly, in accordance with at least one aspect of the presentdisclosure.

FIG. 63B illustrates a side view of the modular energy system of FIG.63A.

FIG. 64A illustrates a modular energy system comprising a latchassembly, in accordance with at least one aspect of the presentdisclosure.

FIG. 64B illustrates a detail view of the modular energy system of FIG.64A.

FIG. 65 illustrates a modular energy system comprising a latch assembly,in accordance with at least one aspect of the present disclosure.

FIG. 66 illustrates a modular energy system comprising a latch assembly,in accordance with at least one aspect of the present disclosure.

FIG. 67 illustrates a modular energy system comprising a cord assembly,in accordance with at least one aspect of the present disclosure.

FIG. 68 illustrates a modular energy system comprising a plug, inaccordance with at least one aspect of the present disclosure.

FIG. 69 illustrates various electrical connections in the modular energysystem of FIG. 60 .

FIG. 70 illustrates a rigid connector, in accordance with at least oneaspect of the present disclosure.

FIG. 71 illustrates a rigid connector, in accordance with at least oneaspect of the present disclosure.

FIG. 72 illustrates a detailed view of the rigid connector of FIG. 71 .

DESCRIPTION

Applicant of the present application owns the following U.S. patentapplications filed on Sep. 5, 2019, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 16/562,123, titled METHOD FOR        CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH        MULTIPLE DEVICES, now U.S. Patent Application Publication No.        2020/0100830;    -   U.S. patent application Ser. No. 16/562,142, titled METHOD FOR        ENERGY DISTRIBUTION IN A SURGICAL MODULAR ENERGY SYSTEM, now        U.S. Patent Application Publication No. 2020/0078070;    -   U.S. patent application Ser. No. 16/562,169, titled SURGICAL        MODULAR ENERGY SYSTEM WITH A SEGMENTED BACKPLANE, now U.S.        Patent Application Publication No. 2020/0078112;    -   U.S. patent application Ser. No. 16/562,185, titled SURGICAL        MODULAR ENERGY SYSTEM WITH FOOTER MODULE, now U.S. Patent        Application Publication No. 2020/0078115;    -   U.S. patent application Ser. No. 16/562,203, titled POWER AND        COMMUNICATION MITIGATION ARRANGEMENT FOR MODULAR SURGICAL ENERGY        SYSTEM, now U.S. Patent Application Publication No.        2020/0078118;    -   U.S. patent application Ser. No. 16/562,212, titled MODULAR        SURGICAL ENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS SENSING        WITH VOLTAGE DETECTION, now U.S. Patent Application Publication        No. 2020/0078119;    -   U.S. patent application Ser. No. 16/562,234, titled MODULAR        SURGICAL ENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS SENSING        WITH TIME COUNTER, now U.S. Patent Application Publication No.        2020/0305945;    -   U.S. patent application Ser. No. 16/562,243, titled MODULAR        SURGICAL ENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS WITH        DIGITAL LOGIC, now U.S. Patent Application Publication No.        2020/0078120;    -   U.S. patent application Ser. No. 16/562,180, titled ENERGY        MODULE FOR DRIVING MULTIPLE ENERGY MODALITIES, now U.S. Patent        Application Publication No. 2020/0078080;    -   U.S. patent application Ser. No. 16/562,184, titled GROUNDING        ARRANGEMENT OF ENERGY MODULES, now U.S. Patent Application        Publication No. 2020/0078081;    -   U.S. patent application Ser. No. 16/562,188, titled BACKPLANE        CONNECTOR DESIGN TO CONNECT STACKED ENERGY MODULES, now U.S.        Patent Application Publication No. 2020/0078116;    -   U.S. patent application Ser. No. 16/562,195, titled ENERGY        MODULE FOR DRIVING MULTIPLE ENERGY MODALITIES THROUGH A PORT,        now U.S. Patent Application Publication No. 2020/0078117;    -   U.S. patent application Ser. No. 16/562,202, titled SURGICAL        INSTRUMENT UTILIZING DRIVE SIGNAL TO POWER SECONDARY FUNCTION,        now U.S. Patent Application Publication No. 2020/0078082;    -   U.S. patent application Ser. No. 16/562,144, titled METHOD FOR        CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE, now U.S.        Pat. No. 11,471,206;    -   U.S. patent application Ser. No. 16/562,151, titled PASSIVE        HEADER MODULE FOR A MODULAR ENERGY SYSTEM, now U.S. Patent        Application Publication No. 2020/0078110;    -   U.S. patent application Ser. No. 16/562,157, titled CONSOLIDATED        USER INTERFACE FOR MODULAR ENERGY SYSTEM, now U.S. Patent        Application Publication No. 2020/0081585;    -   U.S. patent application Ser. No. 16/562,159, titled AUDIO TONE        CONSTRUCTION FOR AN ENERGY MODULE OF A MODULAR ENERGY SYSTEM,        now U.S. Pat. No. 11,218,822;    -   U.S. patent application Ser. No. 16/562,163, titled ADAPTABLY        CONNECTABLE AND REASSIGNABLE SYSTEM ACCESSORIES FOR MODULAR        ENERGY SYSTEM, now U.S. Patent Application Publication No.        2020/0078111;    -   U.S. patent application Ser. No. 16/562,125, titled METHOD FOR        COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL        SYSTEM, now U.S. Patent Application Publication No.        2020/0100825;    -   U.S. patent application Ser. No. 16/562,137, titled FLEXIBLE        HAND-SWITCH CIRCUIT, now U.S. Patent Application Publication No.        2020/0106220;    -   U.S. patent application Ser. No. 16/562,143, titled FIRST AND        SECOND COMMUNICATION PROTOCOL ARRANGEMENT FOR DRIVING PRIMARY        AND SECONDARY DEVICES THROUGH A SINGLE PORT, now U.S. Patent        Application Publication No. 2020/0090808;    -   U.S. patent application Ser. No. 16/562,148, titled FLEXIBLE        NEUTRAL ELECTRODE, now U.S. Pat. No. 11,350,978;    -   U.S. patent application Ser. No. 16/562,154, titled SMART RETURN        PAD SENSING THROUGH MODULATION OF NEAR FIELD COMMUNICATION AND        CONTACT QUALITY MONITORING SIGNALS, now U.S. Patent Application        Publication No. 2020/0078089;    -   U.S. patent application Ser. No. 16/562,162, titled AUTOMATIC        ULTRASONIC ENERGY ACTIVATION CIRCUIT DESIGN FOR MODULAR SURGICAL        SYSTEMS, now U.S. Patent Application Publication No.        2020/0305924;    -   U.S. patent application Ser. No. 16/562,167, titled COORDINATED        ENERGY OUTPUTS OF SEPARATE BUT CONNECTED MODULES, now U.S.        Patent Application Publication No. 2020/0078078;    -   U.S. patent application Ser. No. 16/562,170, titled MANAGING        SIMULTANEOUS MONOPOLAR OUTPUTS USING DUTY CYCLE AND        SYNCHRONIZATION, now U.S. Pat. No. 11,510,720;    -   U.S. patent application Ser. No. 16/562,172 titled PORT PRESENCE        DETECTION SYSTEM FOR MODULAR ENERGY SYSTEM, now U.S. Patent        Application Publication No. 2020/0078113;    -   U.S. patent application Ser. No. 16/562,175, titled INSTRUMENT        TRACKING ARRANGEMENT BASED ON REAL TIME CLOCK INFORMATION, now        U.S. Patent Application Publication No. 2020/0078071;    -   U.S. patent application Ser. No. 16/562,177, titled REGIONAL        LOCATION TRACKING OF COMPONENTS OF A MODULAR ENERGY SYSTEM, now        U.S. Patent Application Publication No. 2020/0078114;    -   U.S. Design patent application No. 29/704,610, titled ENERGY        MODULE, now U.S. Design Pat. No. D928,725;    -   U.S. Design patent application Ser. No. 29/704,614, titled        ENERGY MODULE MONOPOLAR PORT WITH FOURTH SOCKET AMONG THREE        OTHER SOCKETS, now U.S. Design Pat. No. D928,726;    -   U.S. Design patent application Ser. No. 29/704,616, titled        BACKPLANE CONNECTOR FOR ENERGY MODULE, now U.S. Design Pat. No.        D924,139; and    -   U.S. Design patent application Ser. No. 29/704,617, titled ALERT        SCREEN FOR ENERGY MODULE, now U.S. Design Pat. No. D939,545.

Before explaining various aspects of surgical devices and generators indetail, it should be noted that the illustrative examples are notlimited in application or use to the details of construction andarrangement of parts illustrated in the accompanying drawings anddescription. The illustrative examples may be implemented orincorporated in other aspects, variations and modifications, and may bepracticed or carried out in various ways. Further, unless otherwiseindicated, the terms and expressions employed herein have been chosenfor the purpose of describing the illustrative examples for theconvenience of the reader and are not for the purpose of limitationthereof. Also, it will be appreciated that one or more of thefollowing-described aspects, expressions of aspects, and/or examples,can be combined with any one or more of the other following-describedaspects, expressions of aspects and/or examples.

Various aspects are directed to improved ultrasonic surgical devices,electrosurgical devices and generators for use therewith. Aspects of theultrasonic surgical devices can be configured for transecting and/orcoagulating tissue during surgical procedures, for example. Aspects ofthe electrosurgical devices can be configured for transecting,coagulating, scaling, welding and/or desiccating tissue during surgicalprocedures, for example.

Surgical System Hardware

Referring to FIG. 1 , a computer-implemented interactive surgical system100 includes one or more surgical systems 102 and a cloud-based system(e.g., the cloud 104 that may include a remote server 113 coupled to astorage device 105). Each surgical system 102 includes at least onesurgical hub 106 in communication with the cloud 104 that may include aremote server 113. In one example, as illustrated in FIG. 1 , thesurgical system 102 includes a visualization system 108, a roboticsystem 110, and a handheld intelligent surgical instrument 112, whichare configured to communicate with one another and/or the hub 106. Insome aspects, a surgical system 102 may include an M number of hubs 106,an N number of visualization systems 108, an O number of robotic systems110, and a P number of handheld intelligent surgical instruments 112,where M, N, O, and P are integers greater than or equal to one.

FIG. 2 depicts an example of a surgical system 102 being used to performa surgical procedure on a patient who is lying down on an operatingtable 114 in a surgical operating room 116. A robotic system 110 is usedin the surgical procedure as a part of the surgical system 102. Therobotic system 110 includes a surgeon's console 118, a patient side cart120 (surgical robot), and a surgical robotic hub 122. The patient sidecart 120 can manipulate at least one removably coupled surgical tool 117through a minimally invasive incision in the body of the patient whilethe surgeon views the surgical site through the surgeon's console 118.An image of the surgical site can be obtained by a medical imagingdevice 124, which can be manipulated by the patient side cart 120 toorient the imaging device 124. The robotic hub 122 can be used toprocess the images of the surgical site for subsequent display to thesurgeon through the surgeon's console 118.

Other types of robotic systems can be readily adapted for use with thesurgical system 102. Various examples of robotic systems and surgicaltools that are suitable for use with the present disclosure aredescribed in U.S. Provisional Patent Application Ser. No. 62/611,339,titled ROBOT ASSISTED SURGICAL PLATFORM, filed Dec. 28, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

Various examples of cloud-based analytics that are performed by thecloud 104, and are suitable for use with the present disclosure, aredescribed in U.S. Provisional Patent Application Ser. No. 62/611,340,titled CLOUD-BASED MEDICAL ANALYTICS, filed Dec. 28, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

In various aspects, the imaging device 124 includes at least one imagesensor and one or more optical components. Suitable image sensorsinclude, but are not limited to, Charge-Coupled Device (CCD) sensors andComplementary Metal-Oxide Semiconductor (CMOS) sensors.

The optical components of the imaging device 124 may include one or moreillumination sources and/or one or more lenses. The one or moreillumination sources may be directed to illuminate portions of thesurgical field. The one or more image sensors may receive lightreflected or refracted from the surgical field, including lightreflected or refracted from tissue and/or surgical instruments.

The one or more illumination sources may be configured to radiateelectromagnetic energy in the visible spectrum as well as the invisiblespectrum. The visible spectrum, sometimes referred to as the opticalspectrum or luminous spectrum, is that portion of the electromagneticspectrum that is visible to (i.e., can be detected by) the human eye andmay be referred to as visible light or simply light. A typical human eyewill respond to wavelengths in air that are from about 380 nm to about750 nm.

The invisible spectrum (i.e., the non-luminous spectrum) is that portionof the electromagnetic spectrum that lies below and above the visiblespectrum (i.e., wavelengths below about 380 nm and above about 750 nm).The invisible spectrum is not detectable by the human eye. Wavelengthsgreater than about 750 nm are longer than the red visible spectrum, andthey become invisible infrared (IR), microwave, and radioelectromagnetic radiation. Wavelengths less than about 380 nm areshorter than the violet spectrum, and they become invisible ultraviolet,x-ray, and gamma ray electromagnetic radiation.

In various aspects, the imaging device 124 is configured for use in aminimally invasive procedure. Examples of imaging devices suitable foruse with the present disclosure include, but not limited to, anarthroscope, angioscope, bronchoscope, choledochoscope, colonoscope,cytoscope, duodenoscope, enteroscope, esophagogastro-duodenoscope(gastroscope), endoscope, laryngoscope, nasopharyngo-neproscope,sigmoidoscope, thoracoscope, and ureteroscope.

In one aspect, the imaging device employs multi-spectrum monitoring todiscriminate topography and underlying structures. A multi-spectralimage is one that captures image data within specific wavelength rangesacross the electromagnetic spectrum. The wavelengths may be separated byfilters or by the use of instruments that are sensitive to particularwavelengths, including light from frequencies beyond the visible lightrange, e.g., IR and ultraviolet. Spectral imaging can allow extractionof additional information the human eye fails to capture with itsreceptors for red, green, and blue. The use of multi-spectral imaging isdescribed in greater detail under the heading “Advanced ImagingAcquisition Module” in U.S. Provisional Patent Application Ser. No.62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017,the disclosure of which is herein incorporated by reference in itsentirety. Multi-spectrum monitoring can be a useful tool in relocating asurgical field after a surgical task is completed to perform one or moreof the previously described tests on the treated tissue.

It is axiomatic that strict sterilization of the operating room andsurgical equipment is required during any surgery. The strict hygieneand sterilization conditions required in a “surgical theater,” i.e., anoperating or treatment room, necessitate the highest possible sterilityof all medical devices and equipment. Part of that sterilization processis the need to sterilize anything that comes in contact with the patientor penetrates the sterile field, including the imaging device 124 andits attachments and components. It will be appreciated that the sterilefield may be considered a specified area, such as within a tray or on asterile towel, that is considered free of microorganisms, or the sterilefield may be considered an area, immediately around a patient, who hasbeen prepared for a surgical procedure. The sterile field may includethe scrubbed team members, who are properly attired, and all furnitureand fixtures in the area. In various aspects, the visualization system108 includes one or more imaging sensors, one or more image-processingunits, one or more storage arrays, and one or more displays that arestrategically arranged with respect to the sterile field, as illustratedin FIG. 2 . In one aspect, the visualization system 108 includes aninterface for HL7, PACS, and EMR. Various components of thevisualization system 108 are described under the heading “AdvancedImaging Acquisition Module” in U.S. Provisional Patent Application Ser.No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28,2017, the disclosure of which is herein incorporated by reference in itsentirety.

As illustrated in FIG. 2 , a primary display 119 is positioned in thesterile field to be visible to an operator at the operating table 114.In addition, a visualization tower 111 is positioned outside the sterilefield. The visualization tower 111 includes a first non-sterile display107 and a second non-sterile display 109, which face away from eachother. The visualization system 108, guided by the hub 106, isconfigured to utilize the displays 107, 109, and 119 to coordinateinformation flow to operators inside and outside the sterile field. Forexample, the hub 106 may cause the visualization system 108 to display asnapshot of a surgical site, as recorded by an imaging device 124, on anon-sterile display 107 or 109, while maintaining a live feed of thesurgical site on the primary display 119. The snapshot on thenon-sterile display 107 or 109 can permit a non-sterile operator toperform a diagnostic step relevant to the surgical procedure, forexample.

In one aspect, the hub 106 is also configured to route a diagnosticinput or feedback entered by a non-sterile operator at the visualizationtower 111 to the primary display 119 within the sterile field, where itcan be viewed by a sterile operator at the operating table. In oneexample, the input can be in the form of a modification to the snapshotdisplayed on the non-sterile display 107 or 109, which can be routed tothe primary display 119 by the hub 106.

Referring to FIG. 2 , a surgical instrument 112 is being used in thesurgical procedure as part of the surgical system 102. The hub 106 isalso configured to coordinate information flow to a display of thesurgical instrument 112. For example, in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, the disclosure of which is herein incorporated byreference in its entirety. A diagnostic input or feedback entered by anon-sterile operator at the visualization tower 111 can be routed by thehub 106 to the surgical instrument display 115 within the sterile field,where it can be viewed by the operator of the surgical instrument 112.Example surgical instruments that are suitable for use with the surgicalsystem 102 are described under the heading SURGICAL INSTRUMENT HARDWAREand in U.S. Provisional Patent Application Ser. No. 62/611,341, titledINTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017, the disclosure ofwhich is herein incorporated by reference in its entirety, for example.

Referring now to FIG. 3 , a hub 106 is depicted in communication with avisualization system 108, a robotic system 110, and a handheldintelligent surgical instrument 112. The hub 106 includes a hub display135, an imaging module 138, a generator module 140, a communicationmodule 130, a processor module 132, and a storage array 134. In certainaspects, as illustrated in FIG. 3 , the hub 106 further includes a smokeevacuation module 126 and/or a suction/irrigation module 128.

During a surgical procedure, energy application to tissue, for sealingand/or cutting, is generally associated with smoke evacuation, suctionof excess fluid, and/or irrigation of the tissue. Fluid, power, and/ordata lines from different sources are often entangled during thesurgical procedure. Valuable time can be lost addressing this issueduring a surgical procedure. Detangling the lines may necessitatedisconnecting the lines from their respective modules, which may requireresetting the modules. The hub modular enclosure 136 offers a unifiedenvironment for managing the power, data, and fluid lines, which reducesthe frequency of entanglement between such lines.

Aspects of the present disclosure present a surgical hub for use in asurgical procedure that involves energy application to tissue at asurgical site. The surgical hub includes a hub enclosure and a combogenerator module slidably receivable in a docking station of the hubenclosure. The docking station includes data and power contacts. Thecombo generator module includes two or more of an ultrasonic energygenerator component, a bipolar RF energy generator component, and amonopolar RF energy generator component that are housed in a singleunit. In one aspect, the combo generator module also includes a smokeevacuation component, at least one energy delivery cable for connectingthe combo generator module to a surgical instrument, at least one smokeevacuation component configured to evacuate smoke, fluid, and/orparticulates generated by the application of therapeutic energy to thetissue, and a fluid line extending from the remote surgical site to thesmoke evacuation component.

In one aspect, the fluid line is a first fluid line and a second fluidline extends from the remote surgical site to a suction and irrigationmodule slidably received in the hub enclosure. In one aspect, the hubenclosure comprises a fluid interface.

Certain surgical procedures may require the application of more than oneenergy type to the tissue. One energy type may be more beneficial forcutting the tissue, while another different energy type may be morebeneficial for sealing the tissue. For example, a bipolar generator canbe used to seal the tissue while an ultrasonic generator can be used tocut the sealed tissue. Aspects of the present disclosure present asolution where a hub modular enclosure 136 is configured to accommodatedifferent generators, and facilitate an interactive communicationtherebetween. One of the advantages of the hub modular enclosure 136 isenabling the quick removal and/or replacement of various modules.

Aspects of the present disclosure present a modular surgical enclosurefor use in a surgical procedure that involves energy application totissue. The modular surgical enclosure includes a first energy-generatormodule, configured to generate a first energy for application to thetissue, and a first docking station comprising a first docking port thatincludes first data and power contacts, wherein the firstenergy-generator module is slidably movable into an electricalengagement with the power and data contacts and wherein the firstenergy-generator module is slidably movable out of the electricalengagement with the first power and data contacts,

Further to the above, the modular surgical enclosure also includes asecond energy-generator module configured to generate a second energy,different than the first energy, for application to the tissue, and asecond docking station comprising a second docking port that includessecond data and power contacts, wherein the second energy-generatormodule is slidably movable into an electrical engagement with the powerand data contacts, and wherein the second energy-generator module isslidably movable out of the electrical engagement with the second powerand data contacts.

In addition, the modular surgical enclosure also includes acommunication bus between the first docking port and the second dockingport, configured to facilitate communication between the firstenergy-generator module and the second energy-generator module.

Referring to FIGS. 3-7 , aspects of the present disclosure are presentedfor a hub modular enclosure 136 that allows the modular integration of agenerator module 140, a smoke evacuation module 126, and asuction/irrigation module 128. The hub modular enclosure 136 furtherfacilitates interactive communication between the modules 140, 126, 128.As illustrated in FIG. 5 , the generator module 140 can be a generatormodule with integrated monopolar, bipolar, and ultrasonic componentssupported in a single housing unit 139 slidably insertable into the hubmodular enclosure 136. As illustrated in FIG. 5 , the generator module140 can be configured to connect to a monopolar device 146, a bipolardevice 147, and an ultrasonic device 148. Alternatively, the generatormodule 140 may comprise a series of monopolar, bipolar, and/orultrasonic generator modules that interact through the hub modularenclosure 136. The hub modular enclosure 136 can be configured tofacilitate the insertion of multiple generators and interactivecommunication between the generators docked into the hub modularenclosure 136 so that the generators would act as a single generator.

In one aspect, the hub modular enclosure 136 comprises a modular powerand communication backplane 149 with external and wireless communicationheaders to enable the removable attachment of the modules 140, 126, 128and interactive communication therebetween.

In one aspect, the hub modular enclosure 136 includes docking stations,or drawers, 151, herein also referred to as drawers, which areconfigured to slidably receive the modules 140, 126, 128. FIG. 4illustrates a partial perspective view of a surgical hub enclosure 136,and a combo generator module 145 slidably receivable in a dockingstation 151 of the surgical hub enclosure 136. A docking port 152 withpower and data contacts on a rear side of the combo generator module 145is configured to engage a corresponding docking port 150 with power anddata contacts of a corresponding docking station 151 of the hub modularenclosure 136 as the combo generator module 145 is slid into positionwithin the corresponding docking station 151 of the hub module enclosure136. In one aspect, the combo generator module 145 includes a bipolar,ultrasonic, and monopolar module and a smoke evacuation moduleintegrated together into a single housing unit 139, as illustrated inFIG. 5 .

In various aspects, the smoke evacuation module 126 includes a fluidline 154 that conveys captured/collected smoke and/or fluid away from asurgical site and to, for example, the smoke evacuation module 126.Vacuum suction originating from the smoke evacuation module 126 can drawthe smoke into an opening of a utility conduit at the surgical site. Theutility conduit, coupled to the fluid line, can be in the form of aflexible tube terminating at the smoke evacuation module 126. Theutility conduit and the fluid line define a fluid path extending towardthe smoke evacuation module 126 that is received in the hub enclosure136.

In various aspects, the suction/irrigation module 128 is coupled to asurgical tool comprising an aspiration fluid line and a suction fluidline. In one example, the aspiration and suction fluid lines are in theform of flexible tubes extending from the surgical site toward thesuction/irrigation module 128. One or more drive systems can beconfigured to cause irrigation and aspiration of fluids to and from thesurgical site.

In one aspect, the surgical tool includes a shaft having an end effectorat a distal end thereof and at least one energy treatment associatedwith the end effector, an aspiration tube, and an irrigation tube. Theaspiration tube can have an inlet port at a distal end thereof and theaspiration tube extends through the shaft. Similarly, an irrigation tubecan extend through the shaft and can have an inlet port in proximity tothe energy deliver implement. The energy deliver implement is configuredto deliver ultrasonic and/or RF energy to the surgical site and iscoupled to the generator module 140 by a cable extending initiallythrough the shaft.

The irrigation tube can be in fluid communication with a fluid source,and the aspiration tube can be in fluid communication with a vacuumsource. The fluid source and/or the vacuum source can be housed in thesuction/irrigation module 128. In one example, the fluid source and/orthe vacuum source can be housed in the hub enclosure 136 separately fromthe suction/irrigation module 128. In such example, a fluid interfacecan be configured to connect the suction/irrigation module 128 to thefluid source and/or the vacuum source.

In one aspect, the modules 140, 126, 128 and/or their correspondingdocking stations on the hub modular enclosure 136 may include alignmentfeatures that are configured to align the docking ports of the modulesinto engagement with their counterparts in the docking stations of thehub modular enclosure 136. For example, as illustrated in FIG. 4 , thecombo generator module 145 includes side brackets 155 that areconfigured to slidably engage with corresponding brackets 156 of thecorresponding docking station 151 of the hub modular enclosure 136. Thebrackets cooperate to guide the docking port contacts of the combogenerator module 145 into an electrical engagement with the docking portcontacts of the hub modular enclosure 136.

In some aspects, the drawers 151 of the hub modular enclosure 136 arethe same, or substantially the same size, and the modules are adjustedin size to be received in the drawers 151. For example, the sidebrackets 155 and/or 156 can be larger or smaller depending on the sizeof the module. In other aspects, the drawers 151 are different in sizeand are each designed to accommodate a particular module.

Furthermore, the contacts of a particular module can be keyed forengagement with the contacts of a particular drawer to avoid inserting amodule into a drawer with mismatching contacts.

As illustrated in FIG. 4 , the docking port 150 of one drawer 151 can becoupled to the docking port 150 of another drawer 151 through acommunications link 157 to facilitate an interactive communicationbetween the modules housed in the hub modular enclosure 136. The dockingports 150 of the hub modular enclosure 136 may alternatively, oradditionally, facilitate a wireless interactive communication betweenthe modules housed in the hub modular enclosure 136. Any suitablewireless communication can be employed, such as for example AirTitan-Bluetooth.

FIG. 6 illustrates individual power bus attachments for a plurality oflateral docking ports of a lateral modular housing 160 configured toreceive a plurality of modules of a surgical hub 206. The lateralmodular housing 160 is configured to laterally receive and interconnectthe modules 161. The modules 161 are slidably inserted into dockingstations 162 of lateral modular housing 160, which includes a backplanefor interconnecting the modules 161. As illustrated in FIG. 6 , themodules 161 are arranged laterally in the lateral modular housing 160.Alternatively, the modules 161 may be arranged vertically in a lateralmodular housing.

FIG. 7 illustrates a vertical modular housing 164 configured to receivea plurality of modules 165 of the surgical hub 106. The modules 165 areslidably inserted into docking stations, or drawers, 167 of verticalmodular housing 164, which includes a backplane for interconnecting themodules 165. Although the drawers 167 of the vertical modular housing164 are arranged vertically, in certain instances, a vertical modularhousing 164 may include drawers that are arranged laterally.Furthermore, the modules 165 may interact with one another through thedocking ports of the vertical modular housing 164. In the example ofFIG. 7 , a display 177 is provided for displaying data relevant to theoperation of the modules 165. In addition, the vertical modular housing164 includes a master module 178 housing a plurality of sub-modules thatare slidably received in the master module 178.

In various aspects, the imaging module 138 comprises an integrated videoprocessor and a modular light source and is adapted for use with variousimaging devices. In one aspect, the imaging device is comprised of amodular housing that can be assembled with a light source module and acamera module. The housing can be a disposable housing. In at least oneexample, the disposable housing is removably coupled to a reusablecontroller, a light source module, and a camera module. The light sourcemodule and/or the camera module can be selectively chosen depending onthe type of surgical procedure. In one aspect, the camera modulecomprises a CCD sensor. In another aspect, the camera module comprises aCMOS sensor. In another aspect, the camera module is configured forscanned beam imaging. Likewise, the light source module can beconfigured to deliver a white light or a different light, depending onthe surgical procedure.

During a surgical procedure, removing a surgical device from thesurgical field and replacing it with another surgical device thatincludes a different camera or a different light source can beinefficient. Temporarily losing sight of the surgical field may lead toundesirable consequences. The module imaging device of the presentdisclosure is configured to permit the replacement of a light sourcemodule or a camera module midstream during a surgical procedure, withouthaving to remove the imaging device from the surgical field.

In one aspect, the imaging device comprises a tubular housing thatincludes a plurality of channels. A first channel is configured toslidably receive the camera module, which can be configured for asnap-fit engagement with the first channel. A second channel isconfigured to slidably receive the light source module, which can beconfigured for a snap-fit engagement with the second channel. In anotherexample, the camera module and/or the light source module can be rotatedinto a final position within their respective channels. A threadedengagement can be employed in lieu of the snap-fit engagement.

In various examples, multiple imaging devices are placed at differentpositions in the surgical field to provide multiple views. The imagingmodule 138 can be configured to switch between the imaging devices toprovide an optimal view. In various aspects, the imaging module 138 canbe configured to integrate the images from the different imaging device.

Various image processors and imaging devices suitable for use with thepresent disclosure are described in U.S. Pat. No. 7,995,045, titledCOMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, which issued on Aug. 9,2011, which is herein incorporated by reference in its entirety. Inaddition, U.S. Pat. No. 7,982,776, titled SBI MOTION ARTIFACT REMOVALAPPARATUS AND METHOD, which issued on Jul. 19, 2011, which is hereinincorporated by reference in its entirety, describes various systems forremoving motion artifacts from image data. Such systems can beintegrated with the imaging module 138. Furthermore, U.S. PatentApplication Publication No. 2011/0306840, titled CONTROLLABLE MAGNETICSOURCE TO FIXTURE INTRACORPOREAL APPARATUS, which published on Dec. 15,2011, and U.S. Patent Application Publication No. 2014/0243597, titledSYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, whichpublished on Aug. 28, 2014, each of which is herein incorporated byreference in its entirety.

FIG. 8 illustrates a surgical data network 201 comprising a modularcommunication hub 203 configured to connect modular devices located inone or more operating theaters of a healthcare facility, or any room ina healthcare facility specially equipped for surgical operations, to acloud-based system (e.g., the cloud 204 that may include a remote server213 coupled to a storage device 205). In one aspect, the modularcommunication hub 203 comprises a network hub 207 and/or a networkswitch 209 in communication with a network router. The modularcommunication hub 203 also can be coupled to a local computer system 210to provide local computer processing and data manipulation. The surgicaldata network 201 may be configured as passive, intelligent, orswitching. A passive surgical data network serves as a conduit for thedata, enabling it to go from one device (or segment) to another and tothe cloud computing resources. An intelligent surgical data networkincludes additional features to enable the traffic passing through thesurgical data network to be monitored and to configure each port in thenetwork hub 207 or network switch 209. An intelligent surgical datanetwork may be referred to as a manageable hub or switch. A switchinghub reads the destination address of each packet and then forwards thepacket to the correct port.

Modular devices 1 a-1 n located in the operating theater may be coupledto the modular communication hub 203. The network hub 207 and/or thenetwork switch 209 may be coupled to a network router 211 to connect thedevices 1 a-1 n to the cloud 204 or the local computer system 210. Dataassociated with the devices 1 a-1 n may be transferred to cloud-basedcomputers via the router for remote data processing and manipulation.Data associated with the devices 1 a-1 n may also be transferred to thelocal computer system 210 for local data processing and manipulation.Modular devices 2 a-2 m located in the same operating theater also maybe coupled to a network switch 209. The network switch 209 may becoupled to the network hub 207 and/or the network router 211 to connectto the devices 2 a-2 m to the cloud 204. Data associated with thedevices 2 a-2 n may be transferred to the cloud 204 via the networkrouter 211 for data processing and manipulation. Data associated withthe devices 2 a-2 m may also be transferred to the local computer system210 for local data processing and manipulation.

It will be appreciated that the surgical data network 201 may beexpanded by interconnecting multiple network hubs 207 and/or multiplenetwork switches 209 with multiple network routers 211. The modularcommunication hub 203 may be contained in a modular control towerconfigured to receive multiple devices 1 a-1 n/2 a-2 m. The localcomputer system 210 also may be contained in a modular control tower.The modular communication hub 203 is connected to a display 212 todisplay images obtained by some of the devices 1 a-1 n/2 a-2 m, forexample during surgical procedures. In various aspects, the devices 1a-1 n/2 a-2 m may include, for example, various modules such as animaging module 138 coupled to an endoscope, a generator module 140coupled to an energy-based surgical device, a smoke evacuation module126, a suction/irrigation module 128, a communication module 130, aprocessor module 132, a storage array 134, a surgical device coupled toa display, and/or a non-contact sensor module, among other modulardevices that may be connected to the modular communication hub 203 ofthe surgical data network 201.

In one aspect, the surgical data network 201 may comprise a combinationof network hub(s), network switch(es), and network router(s) connectingthe devices 1 a-1 n/2 a-2 m to the cloud. Any one of or all of thedevices 1 a-1 n/2 a-2 m coupled to the network hub or network switch maycollect data in real time and transfer the data to cloud computers fordata processing and manipulation. It will be appreciated that cloudcomputing relies on sharing computing resources rather than having localservers or personal devices to handle software applications. The word“cloud” may be used as a metaphor for “the Internet,” although the termis not limited as such. Accordingly, the term “cloud computing” may beused herein to refer to “a type of Internet-based computing,” wheredifferent services—such as servers, storage, and applications—aredelivered to the modular communication hub 203 and/or computer system210 located in the surgical theater (e.g., a fixed, mobile, temporary,or field operating room or space) and to devices connected to themodular communication hub 203 and/or computer system 210 through theInternet. The cloud infrastructure may be maintained by a cloud serviceprovider. In this context, the cloud service provider may be the entitythat coordinates the usage and control of the devices 1 a-1 n/2 a-2 mlocated in one or more operating theaters. The cloud computing servicescan perform a large number of calculations based on the data gathered bysmart surgical instruments, robots, and other computerized deviceslocated in the operating theater. The hub hardware enables multipledevices or connections to be connected to a computer that communicateswith the cloud computing resources and storage.

Applying cloud computer data processing techniques on the data collectedby the devices 1 a-1 n/2 a-2 m, the surgical data network providesimproved surgical outcomes, reduced costs, and improved patientsatisfaction. At least some of the devices 1 a-1 n/2 a-2 m may beemployed to view tissue states to assess leaks or perfusion of sealedtissue after a tissue sealing and cutting procedure. At least some ofthe devices 1 a-1 n/2 a-2 m may be employed to identify pathology, suchas the effects of diseases, using the cloud-based computing to examinedata including images of samples of body tissue for diagnostic purposes.This includes localization and margin confirmation of tissue andphenotypes. At least some of the devices 1 a-1 n/2 a-2 m may be employedto identify anatomical structures of the body using a variety of sensorsintegrated with imaging devices and techniques such as overlaying imagescaptured by multiple imaging devices. The data gathered by the devices 1a-1 n/2 a-2 m, including image data, may be transferred to the cloud 204or the local computer system 210 or both for data processing andmanipulation including image processing and manipulation. The data maybe analyzed to improve surgical procedure outcomes by determining iffurther treatment, such as the application of endoscopic intervention,emerging technologies, a targeted radiation, targeted intervention, andprecise robotics to tissue-specific sites and conditions, may bepursued. Such data analysis may further employ outcome analyticsprocessing, and using standardized approaches may provide beneficialfeedback to either confirm surgical treatments and the behavior of thesurgeon or suggest modifications to surgical treatments and the behaviorof the surgeon.

In one implementation, the operating theater devices 1 a-1 n may beconnected to the modular communication hub 203 over a wired channel or awireless channel depending on the configuration of the devices 1 a-1 nto a network hub. The network hub 207 may be implemented, in one aspect,as a local network broadcast device that works on the physical layer ofthe Open System Interconnection (OSI) model. The network hub providesconnectivity to the devices 1 a-1 n located in the same operatingtheater network. The network hub 207 collects data in the form ofpackets and sends them to the router in half duplex mode. The networkhub 207 does not store any media access control/Internet Protocol(MAC/IP) to transfer the device data. Only one of the devices 1 a-1 ncan send data at a time through the network hub 207. The network hub 207has no routing tables or intelligence regarding where to sendinformation and broadcasts all network data across each connection andto a remote server 213 (FIG. 9 ) over the cloud 204. The network hub 207can detect basic network errors such as collisions, but having allinformation broadcast to multiple ports can be a security risk and causebottlenecks.

In another implementation, the operating theater devices 2 a-2 m may beconnected to a network switch 209 over a wired channel or a wirelesschannel. The network switch 209 works in the data link layer of the OSImodel. The network switch 209 is a multicast device for connecting thedevices 2 a-2 m located in the same operating theater to the network.The network switch 209 sends data in the form of frames to the networkrouter 211 and works in full duplex mode. Multiple devices 2 a-2 m cansend data at the same time through the network switch 209. The networkswitch 209 stores and uses MAC addresses of the devices 2 a-2 m totransfer data.

The network hub 207 and/or the network switch 209 are coupled to thenetwork router 211 for connection to the cloud 204. The network router211 works in the network layer of the OSI model. The network router 211creates a route for transmitting data packets received from the networkhub 207 and/or network switch 211 to cloud-based computer resources forfurther processing and manipulation of the data collected by any one ofor all the devices 1 a-1 n/2 a-2 m. The network router 211 may beemployed to connect two or more different networks located in differentlocations, such as, for example, different operating theaters of thesame healthcare facility or different networks located in differentoperating theaters of different healthcare facilities. The networkrouter 211 sends data in the form of packets to the cloud 204 and worksin full duplex mode. Multiple devices can send data at the same time.The network router 211 uses IP addresses to transfer data.

In one example, the network hub 207 may be implemented as a USB hub,which allows multiple USB devices to be connected to a host computer.The USB hub may expand a single USB port into several tiers so thatthere are more ports available to connect devices to the host systemcomputer. The network hub 207 may include wired or wireless capabilitiesto receive information over a wired channel or a wireless channel. Inone aspect, a wireless USB short-range, high-bandwidth wireless radiocommunication protocol may be employed for communication between thedevices 1 a-1 n and devices 2 a-2 m located in the operating theater.

In other examples, the operating theater devices 1 a-1 n/2 a-2 m maycommunicate to the modular communication hub 203 via Bluetooth wirelesstechnology standard for exchanging data over short distances (usingshort-wavelength UHF radio waves in the ISM band from 2.4 to 2.485 GHz)from fixed and mobile devices and building personal area networks(PANs). In other aspects, the operating theater devices 1 a-1 n/2 a-2 mmay communicate to the modular communication hub 203 via a number ofwireless or wired communication standards or protocols, including butnot limited to Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family),IEEE 802.20, long-term evolution (LTE), and Ev-DO, HSPA+, HSDPA+,HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivativesthereof, as well as any other wireless and wired protocols that aredesignated as 3G, 4G, 5G, and beyond. The computing module may include aplurality of communication modules. For instance, a first communicationmodule may be dedicated to shorter-range wireless communications such asWi-Fi and Bluetooth, and a second communication module may be dedicatedto longer-range wireless communications such as GPS, EDGE, GPRS, CDMA,WiMAX, LTE, Ev-DO, and others.

The modular communication hub 203 may serve as a central connection forone or all of the operating theater devices 1 a-1 n/2 a-2 m and handlesa data type known as frames. Frames carry the data generated by thedevices 1 a-1 n/2 a-2 m. When a frame is received by the modularcommunication hub 203, it is amplified and transmitted to the networkrouter 211, which transfers the data to the cloud computing resources byusing a number of wireless or wired communication standards orprotocols, as described herein.

The modular communication hub 203 can be used as a standalone device orbe connected to compatible network hubs and network switches to form alarger network. The modular communication hub 203 is generally easy toinstall, configure, and maintain, making it a good option for networkingthe operating theater devices 1 a-1 n/2 a-2 m.

FIG. 9 illustrates a computer-implemented interactive surgical system200. The computer-implemented interactive surgical system 200 is similarin many respects to the computer-implemented interactive surgical system100. For example, the computer-implemented interactive surgical system200 includes one or more surgical systems 202, which are similar in manyrespects to the surgical systems 102. Each surgical system 202 includesat least one surgical hub 206 in communication with a cloud 204 that mayinclude a remote server 213. In one aspect, the computer-implementedinteractive surgical system 200 comprises a modular control tower 236connected to multiple operating theater devices such as, for example,intelligent surgical instruments, robots, and other computerized deviceslocated in the operating theater. As shown in FIG. 10 , the modularcontrol tower 236 comprises a modular communication hub 203 coupled to acomputer system 210. As illustrated in the example of FIG. 9 , themodular control tower 236 is coupled to an imaging module 238 that iscoupled to an endoscope 239, a generator module 240 that is coupled toan energy device 241, a smoke evacuator module 226, a suction/irrigationmodule 228, a communication module 230, a processor module 232, astorage array 234, a smart device/instrument 235 optionally coupled to adisplay 237, and a non-contact sensor module 242. The operating theaterdevices are coupled to cloud computing resources and data storage viathe modular control tower 236. A robot hub 222 also may be connected tothe modular control tower 236 and to the cloud computing resources. Thedevices/instruments 235, visualization systems 208, among others, may becoupled to the modular control tower 236 via wired or wirelesscommunication standards or protocols, as described herein. The modularcontrol tower 236 may be coupled to a hub display 215 (e.g., monitor,screen) to display and overlay images received from the imaging module,device/instrument display, and/or other visualization systems 208. Thehub display also may display data received from devices connected to themodular control tower in conjunction with images and overlaid images.

FIG. 10 illustrates a surgical hub 206 comprising a plurality of modulescoupled to the modular control tower 236. The modular control tower 236comprises a modular communication hub 203, e.g., a network connectivitydevice, and a computer system 210 to provide local processing,visualization, and imaging, for example. As shown in FIG. 10 , themodular communication hub 203 may be connected in a tiered configurationto expand the number of modules (e.g., devices) that may be connected tothe modular communication hub 203 and transfer data associated with themodules to the computer system 210, cloud computing resources, or both.As shown in FIG. 10 , each of the network hubs/switches in the modularcommunication hub 203 includes three downstream ports and one upstreamport. The upstream network hub/switch is connected to a processor toprovide a communication connection to the cloud computing resources anda local display 217. Communication to the cloud 204 may be made eitherthrough a wired or a wireless communication channel.

The surgical hub 206 employs a non-contact sensor module 242 to measurethe dimensions of the operating theater and generate a map of thesurgical theater using either ultrasonic or laser-type non-contactmeasurement devices. An ultrasound-based non-contact sensor module scansthe operating theater by transmitting a burst of ultrasound andreceiving the echo when it bounces off the perimeter walls of anoperating theater as described under the heading “Surgical Hub SpatialAwareness Within an Operating Room” in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, which is herein incorporated by reference in itsentirety, in which the sensor module is configured to determine the sizeof the operating theater and to adjust Bluetooth-pairing distancelimits. A laser-based non-contact sensor module scans the operatingtheater by transmitting laser light pulses, receiving laser light pulsesthat bounce off the perimeter walls of the operating theater, andcomparing the phase of the transmitted pulse to the received pulse todetermine the size of the operating theater and to adjust Bluetoothpairing distance limits, for example.

The computer system 210 comprises a processor 244 and a networkinterface 245. The processor 244 is coupled to a communication module247, storage 248, memory 249, non-volatile memory 250, and input/outputinterface 251 via a system bus. The system bus can be any of severaltypes of bus structure(s) including the memory bus or memory controller,a peripheral bus or external bus, and/or a local bus using any varietyof available bus architectures including, but not limited to, 9-bit bus,Industrial Standard Architecture (ISA), Micro-Charmel Architecture(MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESALocal Bus (VLB), Peripheral Component Interconnect (PCI), USB, AdvancedGraphics Port (AGP), Personal Computer Memory Card InternationalAssociation bus (PCMCIA), Small Computer Systems Interface (SCSI), orany other proprietary bus.

The processor 244 may be any single-core or multicore processor such asthose known under the trade name ARM Cortex by Texas Instruments. In oneaspect, the processor may be an LM4F230H5QR ARM Cortex-M4F ProcessorCore, available from Texas Instruments, for example, comprising anon-chip memory of 256 KB single-cycle flash memory, or othernon-volatile memory, up to 40 MHz, a prefetch buffer to improveperformance above 40 MHz, a 32 KB single-cycle serial random accessmemory (SRAM), an internal read-only memory (ROM) loaded withStellarisWare® software, a 2 KB electrically erasable programmableread-only memory (EEPROM), and/or one or more pulse width modulation(PWM) modules, one or more quadrature encoder inputs (QEI) analogs, oneor more 12-bit analog-to-digital converters (ADCs) with 12 analog inputchannels, details of which are available for the product datasheet.

In one aspect, the processor 244 may comprise a safety controllercomprising two controller-based families such as TMS570 and RM4x, knownunder the trade name Hercules ARM Cortex R4, also by Texas Instruments.The safety controller may be configured specifically for IEC 61508 andISO 26262 safety critical applications, among others, to provideadvanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The system memory includes volatile memory and non-volatile memory. Thebasic input/output system (BIOS), containing the basic routines totransfer information between elements within the computer system, suchas during start-up, is stored in non-volatile memory. For example, thenon-volatile memory can include ROM, programmable ROM (PROM),electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatilememory includes random-access memory (RAM), which acts as external cachememory. Moreover, RAM is available in many forms such as SRAM, dynamicRAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and directRambus RAM (DRRAM).

The computer system 210 also includes removable/non-removable,volatile/non-volatile computer storage media, such as for example diskstorage. The disk storage includes, but is not limited to, devices likea magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zipdrive, LS-60 drive, flash memory card, or memory stick. In addition, thedisk storage can include storage media separately or in combination withother storage media including, but not limited to, an optical disc drivesuch as a compact disc ROM device (CD-ROM), compact disc recordabledrive (CD-R Drive), compact disc rewritable drive (CD-RW Drive), or adigital versatile disc ROM drive (DVD-ROM). To facilitate the connectionof the disk storage devices to the system bus, a removable ornon-removable interface may be employed.

It is to be appreciated that the computer system 210 includes softwarethat acts as an intermediary between users and the basic computerresources described in a suitable operating environment. Such softwareincludes an operating system. The operating system, which can be storedon the disk storage, acts to control and allocate resources of thecomputer system. System applications take advantage of the management ofresources by the operating system through program modules and programdata stored either in the system memory or on the disk storage. It is tobe appreciated that various components described herein can beimplemented with various operating systems or combinations of operatingsystems.

A user enters commands or information into the computer system 210through input device(s) coupled to the I/O interface 251. The inputdevices include, but are not limited to, a pointing device such as amouse, trackball, stylus, touch pad, keyboard, microphone, joystick,game pad, satellite dish, scanner, TV tuner card, digital camera,digital video camera, web camera, and the like. These and other inputdevices connect to the processor through the system bus via interfaceport(s). The interface port(s) include, for example, a serial port, aparallel port, a game port, and a USB. The output device(s) use some ofthe same types of ports as input device(s). Thus, for example, a USBport may be used to provide input to the computer system and to outputinformation from the computer system to an output device. An outputadapter is provided to illustrate that there are some output deviceslike monitors, displays, speakers, and printers, among other outputdevices that require special adapters. The output adapters include, byway of illustration and not limitation, video and sound cards thatprovide a means of connection between the output device and the systembus. It should be noted that other devices and/or systems of devices,such as remote computer(s), provide both input and output capabilities.

The computer system 210 can operate in a networked environment usinglogical connections to one or more remote computers, such as cloudcomputer(s), or local computers. The remote cloud computer(s) can be apersonal computer, server, router, network PC, workstation,microprocessor-based appliance, peer device, or other common networknode, and the like, and typically includes many or all of the elementsdescribed relative to the computer system. For purposes of brevity, onlya memory storage device is illustrated with the remote computer(s). Theremote computer(s) is logically connected to the computer system througha network interface and then physically connected via a communicationconnection. The network interface encompasses communication networkssuch as local area networks (LANs) and wide area networks (WANs). LANtechnologies include Fiber Distributed Data Interface (FDDI), CopperDistributed Data Interface (CDDI), Ethernet/IEEE 802.3, Token Ring/IEEE802.5 and the like. WAN technologies include, but are not limited to,point-to-point links, circuit-switching networks like IntegratedServices Digital Networks (ISDN) and variations thereon,packet-switching networks, and Digital Subscriber Lines (DSL).

In various aspects, the computer system 210 of FIG. 10 , the imagingmodule 238 and/or visualization system 208, and/or the processor module232 of FIGS. 9-10 , may comprise an image processor, image-processingengine, media processor, or any specialized digital signal processor(DSP) used for the processing of digital images. The image processor mayemploy parallel computing with single instruction, multiple data (SIMD)or multiple instruction, multiple data (MIMD) technologies to increasespeed and efficiency. The digital image-processing engine can perform arange of tasks. The image processor may be a system on a chip withmulticore processor architecture.

The communication connection(s) refers to the hardware/software employedto connect the network interface to the bus. While the communicationconnection is shown for illustrative clarity inside the computer system,it can also be external to the computer system 210. Thehardware/software necessary for connection to the network interfaceincludes, for illustrative purposes only, internal and externaltechnologies such as modems, including regular telephone-grade modems,cable modems, and DSL modems, ISDN adapters, and Ethernet cards.

FIG. 11 illustrates a functional block diagram of one aspect of a USBnetwork hub 300 device, in accordance with at least one aspect of thepresent disclosure. In the illustrated aspect, the USB network hubdevice 300 employs a TUSB2036 integrated circuit hub by TexasInstruments. The USB network hub 300 is a CMOS device that provides anupstream USB transceiver port 302 and up to three downstream USBtransceiver ports 304, 306, 308 in compliance with the USB 2.0specification. The upstream USB transceiver port 302 is a differentialroot data port comprising a differential data minus (DM0) input pairedwith a differential data plus (DP0) input. The three downstream USBtransceiver ports 304, 306, 308 are differential data ports where eachport includes differential data plus (DP1-DP3) outputs paired withdifferential data minus (DM1-DM3) outputs.

The USB network hub 300 device is implemented with a digital statemachine instead of a microcontroller, and no firmware programming isrequired. Fully compliant USB transceivers are integrated into thecircuit for the upstream USB transceiver port 302 and all downstream USBtransceiver ports 304, 306, 308. The downstream USB transceiver ports304, 306, 308 support both full-speed and low-speed devices byautomatically setting the slew rate according to the speed of the deviceattached to the ports. The USB network hub 300 device may be configuredeither in bus-powered or self-powered mode and includes a hub powerlogic 312 to manage power.

The USB network hub 300 device includes a serial interface engine 310(SIE). The SIE 310 is the front end of the USB network hub 300 hardwareand handles most of the protocol described in chapter 8 of the USBspecification. The SIE 310 typically comprehends signaling up to thetransaction level. The functions that it handles could include: packetrecognition, transaction sequencing, SOP, EOP, RESET, and RESUME signaldetection/generation, clock/data separation, non-return-to-zero invert(NRZI) data encoding/decoding and bit-stuffing, CRC generation andchecking (token and data), packet ID (PID) generation andchecking/decoding, and/or serial-parallel/parallel-serial conversion.The 310 receives a clock input 314 and is coupled to a suspend/resumelogic and frame timer 316 circuit and a hub repeater circuit 318 tocontrol communication between the upstream USB transceiver port 302 andthe downstream USB transceiver ports 304, 306, 308 through port logiccircuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326via interface logic to control commands from a serial EEPROM via aserial EEPROM interface 330.

In various aspects, the USB network hub 300 can connect 127 functionsconfigured in up to six logical layers (tiers) to a single computer.Further, the USB network hub 300 can connect to all peripherals using astandardized four-wire cable that provides both communication and powerdistribution. The power configurations are bus-powered and self-poweredmodes. The USB network hub 300 may be configured to support four modesof power management: a bus-powered hub, with either individual-portpower management or ganged-port power management, and the self-poweredhub, with either individual-port power management or ganged-port powermanagement. In one aspect, using a USB cable, the USB network hub 300,the upstream USB transceiver port 302 is plugged into a USB hostcontroller, and the downstream USB transceiver ports 304, 306, 308 areexposed for connecting USB compatible devices, and so forth.

Surgical Instrument Hardware

FIG. 12 illustrates a logic diagram of a control system 470 of asurgical instrument or tool in accordance with one or more aspects ofthe present disclosure. The system 470 comprises a control circuit. Thecontrol circuit includes a microcontroller 461 comprising a processor462 and a memory 468. One or more of sensors 472, 474, 476, for example,provide real-time feedback to the processor 462. A motor 482, driven bya motor driver 492, operably couples a longitudinally movabledisplacement member to drive a clamp arm closure member. A trackingsystem 480 is configured to determine the position of the longitudinallymovable displacement member. The position information is provided to theprocessor 462, which can be programmed or configured to determine theposition of the longitudinally movable drive member as well as theposition of the closure member. Additional motors may be provided at thetool driver interface to control closure tube travel, shaft rotation,articulation, or clamp arm closure, or a combination of the above. Adisplay 473 displays a variety of operating conditions of theinstruments and may include touch screen functionality for data input.Information displayed on the display 473 may be overlaid with imagesacquired via endoscopic imaging modules.

In one aspect, the microcontroller 461 may be any single-core ormulticore processor such as those known under the trade name ARM Cortexby Texas Instruments. In one aspect, the main microcontroller 461 may bean LM4F230H5QR ARM Cortex-M4F Processor Core, available from TexasInstruments, for example, comprising an on-chip memory of 256 KBsingle-cycle flash memory, or other non-volatile memory, up to 40 MHz, aprefetch buffer to improve performance above 40 MHz, a 32 KBsingle-cycle SRAM, and internal ROM loaded with StellarisWare® software,a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, and/orone or more 12-bit ADCs with 12 analog input channels, details of whichare available for the product datasheet.

In one aspect, the microcontroller 461 may comprise a safety controllercomprising two controller-based families such as TMS570 and RM4x, knownunder the trade name Hercules ARM Cortex R4, also by Texas Instruments.The safety controller may be configured specifically for IEC 61508 andISO 26262 safety critical applications, among others, to provideadvanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The microcontroller 461 may be programmed to perform various functionssuch as precise control over the speed and position of the knife,articulation systems, clamp arm, or a combination of the above. In oneaspect, the microcontroller 461 includes a processor 462 and a memory468. The electric motor 482 may be a brushed direct current (DC) motorwith a gearbox and mechanical links to an articulation or knife system.In one aspect, a motor driver 492 may be an A3941 available from AllegroMicrosystems, Inc. Other motor drivers may be readily substituted foruse in the tracking system 480 comprising an absolute positioningsystem. A detailed description of an absolute positioning system isdescribed in U.S. Patent Application Publication No. 2017/0296213,titled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING ANDCUTTING INSTRUMENT, which published on Oct. 19, 2017, which is hereinincorporated by reference in its entirety.

The microcontroller 461 may be programmed to provide precise controlover the speed and position of displacement members and articulationsystems. The microcontroller 461 may be configured to compute a responsein the software of the microcontroller 461. The computed response iscompared to a measured response of the actual system to obtain an“observed” response, which is used for actual feedback decisions. Theobserved response is a favorable, tuned value that balances the smooth,continuous nature of the simulated response with the measured response,which can detect outside influences on the system.

In one aspect, the motor 482 may be controlled by the motor driver 492and can be employed by the firing system of the surgical instrument ortool. In various forms, the motor 482 may be a brushed DC driving motorhaving a maximum rotational speed of approximately 25,000 RPM. In otherarrangements, the motor 482 may include a brushless motor, a cordlessmotor, a synchronous motor, a stepper motor, or any other suitableelectric motor. The motor driver 492 may comprise an H-bridge drivercomprising field-effect transistors (FETs), for example. The motor 482can be powered by a power assembly releasably mounted to the handleassembly or tool housing for supplying control power to the surgicalinstrument or tool. The power assembly may comprise a battery which mayinclude a number of battery cells connected in series that can be usedas the power source to power the surgical instrument or tool. In certaincircumstances, the battery cells of the power assembly may bereplaceable and/or rechargeable battery cells. In at least one example,the battery cells can be lithium-ion batteries which can be couplable toand separable from the power assembly.

The motor driver 492 may be an A3941 available from AllegroMicrosystems, Inc. The A3941 492 is a full-bridge controller for usewith external N-channel power metal-oxide semiconductor field-effecttransistors (MOSFETs) specifically designed for inductive loads, such asbrush DC motors. The driver 492 comprises a unique charge pump regulatorthat provides full (>10 V) gate drive for battery voltages down to 7 Vand allows the A3941 to operate with a reduced gate drive, down to 5.5V. A bootstrap capacitor may be employed to provide the above batterysupply voltage required for N-channel MOSFETs. An internal charge pumpfor the high-side drive allows DC (100% duty cycle) operation. The fullbridge can be driven in fast or slow decay modes using diode orsynchronous rectification. In the slow decay mode, current recirculationcan be through the high-side or the low-side FETs. The power FETs areprotected from shoot-through by resistor-adjustable dead time.Integrated diagnostics provide indications of undervoltage,overtemperature, and power bridge faults and can be configured toprotect the power MOSFETs under most short circuit conditions. Othermotor drivers may be readily substituted for use in the tracking system480 comprising an absolute positioning system.

The tracking system 480 comprises a controlled motor drive circuitarrangement comprising a position sensor 472 according to one aspect ofthis disclosure. The position sensor 472 for an absolute positioningsystem provides a unique position signal corresponding to the locationof a displacement member. In one aspect, the displacement memberrepresents a longitudinally movable drive member comprising a rack ofdrive teeth for meshing engagement with a corresponding drive gear of agear reducer assembly. In other aspects, the displacement memberrepresents the firing member, which could be adapted and configured toinclude a rack of drive teeth. In yet another aspect, the displacementmember represents a longitudinal displacement member to open and close aclamp arm, which can be adapted and configured to include a rack ofdrive teeth. In other aspects, the displacement member represents aclamp arm closure member configured to close and to open a clamp arm ofa stapler, ultrasonic, or electrosurgical device, or combinations of theabove. Accordingly, as used herein, the term displacement member is usedgenerically to refer to any movable member of the surgical instrument ortool such as the drive member, the clamp arm, or any element that can bedisplaced. Accordingly, the absolute positioning system can, in effect,track the displacement of the clamp arm by tracking the lineardisplacement of the longitudinally movable drive member. In otheraspects, the absolute positioning system can be configured to track theposition of a clamp arm in the process of closing or opening. In variousother aspects, the displacement member may be coupled to any positionsensor 472 suitable for measuring linear displacement. Thus, thelongitudinally movable drive member, or clamp arm, or combinationsthereof, may be coupled to any suitable linear displacement sensor.Linear displacement sensors may include contact or non-contactdisplacement sensors. Linear displacement sensors may comprise linearvariable differential transformers (LVDT), differential variablereluctance transducers (DVRT), a slide potentiometer, a magnetic sensingsystem comprising a movable magnet and a series of linearly arrangedHall effect sensors, a magnetic sensing system comprising a fixed magnetand a series of movable, linearly arranged Hall effect sensors, anoptical sensing system comprising a movable light source and a series oflinearly arranged photo diodes or photo detectors, an optical sensingsystem comprising a fixed light source and a series of movable linearly,arranged photo diodes or photo detectors, or any combination thereof.

The electric motor 482 can include a rotatable shaft that operablyinterfaces with a gear assembly that is mounted in meshing engagementwith a set, or rack, of drive teeth on the displacement member. A sensorelement may be operably coupled to a gear assembly such that a singlerevolution of the position sensor 472 element corresponds to some linearlongitudinal translation of the displacement member. An arrangement ofgearing and sensors can be connected to the linear actuator, via a rackand pinion arrangement, or a rotary actuator, via a spur gear or otherconnection. A power source supplies power to the absolute positioningsystem and an output indicator may display the output of the absolutepositioning system. The displacement member represents thelongitudinally movable drive member comprising a rack of drive teethformed thereon for meshing engagement with a corresponding drive gear ofthe gear reducer assembly. The displacement member represents thelongitudinally movable firing member to open and close a clamp arm.

A single revolution of the sensor element associated with the positionsensor 472 is equivalent to a longitudinal linear displacement d₁ of thedisplacement member, where d₁ is the longitudinal linear distance thatthe displacement member moves from point “a” to point “b” after a singlerevolution of the sensor element coupled to the displacement member. Thesensor arrangement may be connected via a gear reduction that results inthe position sensor 472 completing one or more revolutions for the fullstroke of the displacement member. The position sensor 472 may completemultiple revolutions for the full stroke of the displacement member.

A series of switches, where n is an integer greater than one, may beemployed alone or in combination with a gear reduction to provide aunique position signal for more than one revolution of the positionsensor 472. The state of the switches are fed back to themicrocontroller 461 that applies logic to determine a unique positionsignal corresponding to the longitudinal linear displacement d₁+d₂+ . .. do of the displacement member. The output of the position sensor 472is provided to the microcontroller 461. The position sensor 472 of thesensor arrangement may comprise a magnetic sensor, an analog rotarysensor like a potentiometer, or an array of analog Hall-effect elements,which output a unique combination of position signals or values.

The position sensor 472 may comprise any number of magnetic sensingelements, such as, for example, magnetic sensors classified according towhether they measure the total magnetic field or the vector componentsof the magnetic field. The techniques used to produce both types ofmagnetic sensors encompass many aspects of physics and electronics. Thetechnologies used for magnetic field sensing include search coil,fluxgate, optically pumped, nuclear precession, SQUID, Hall-effect,anisotropic magnetoresistance, giant magnetoresistance, magnetic tunneljunctions, giant magnetoimpedance, magnetostrictive/piezoelectriccomposites, magnetodiode, magnetotransistor, fiber-optic, magneto-optic,and microelectromechanical systems-based magnetic sensors, among others.

In one aspect, the position sensor 472 for the tracking system 480comprising an absolute positioning system comprises a magnetic rotaryabsolute positioning system. The position sensor 472 may be implementedas an AS5055EQFT single-chip magnetic rotary position sensor availablefrom Austria Microsystems, AG. The position sensor 472 is interfacedwith the microcontroller 461 to provide an absolute positioning system.The position sensor 472 is a low-voltage and low-power component andincludes four Hall-effect elements in an area of the position sensor 472that is located above a magnet. A high-resolution ADC and a smart powermanagement controller are also provided on the chip. A coordinaterotation digital computer (CORDIC) processor, also known as thedigit-by-digit method and Volder's algorithm, is provided to implement asimple and efficient algorithm to calculate hyperbolic and trigonometricfunctions that require only addition, subtraction, bitshift, and tablelookup operations. The angle position, alarm bits, and magnetic fieldinformation are transmitted over a standard serial communicationinterface, such as a serial peripheral interface (SPI) interface, to themicrocontroller 461. The position sensor 472 provides 12 or 14 bits ofresolution. The position sensor 472 may be an AS5055 chip provided in asmall QFN 16-pin 4×4×0.85 mm package.

The tracking system 480 comprising an absolute positioning system maycomprise and/or be programmed to implement a feedback controller, suchas a PID, state feedback, and adaptive controller. A power sourceconverts the signal from the feedback controller into a physical inputto the system: in this case the voltage. Other examples include a PWM ofthe voltage, current, and force. Other sensor(s) may be provided tomeasure physical parameters of the physical system in addition to theposition measured by the position sensor 472. In some aspects, the othersensor(s) can include sensor arrangements such as those described inU.S. Pat. No. 9,345,481, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM, which issued on May 24, 2016, which is herein incorporated byreference in its entirety; U.S. Patent Application Publication No.2014/0263552, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,which published on Sep. 18, 2014, which is herein incorporated byreference in its entirety; and U.S. patent application Ser. No.15/628,175, titled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OFA SURGICAL STAPLING AND CUTTING INSTRUMENT, filed Jun. 20, 2017, whichis herein incorporated by reference in its entirety. In a digital signalprocessing system, an absolute positioning system is coupled to adigital data acquisition system where the output of the absolutepositioning system will have a finite resolution and sampling frequency.The absolute positioning system may comprise a compare-and-combinecircuit to combine a computed response with a measured response usingalgorithms, such as a weighted average and a theoretical control loop,that drive the computed response towards the measured response. Thecomputed response of the physical system takes into account propertieslike mass, inertia, viscous friction, inductance resistance, etc., topredict what the states and outputs of the physical system will be byknowing the input.

The absolute positioning system provides an absolute position of thedisplacement member upon power-up of the instrument, without retractingor advancing the displacement member to a reset (zero or home) positionas may be required with conventional rotary encoders that merely countthe number of steps forwards or backwards that the motor 482 has takento infer the position of a device actuator, drive bar, knife, or thelike.

A sensor 474, such as, for example, a strain gauge or a micro-straingauge, is configured to measure one or more parameters of the endeffector, such as, for example, the amplitude of the strain exerted onthe anvil during a clamping operation, which can be indicative of theclosure forces applied to the anvil. The measured strain is converted toa digital signal and provided to the processor 462. Alternatively, or inaddition to the sensor 474, a sensor 476, such as, for example, a loadsensor, can measure the closure force applied by the closure drivesystem to the anvil in a stapler or a clamp arm in an ultrasonic orelectrosurgical instrument. The sensor 476, such as, for example, a loadsensor, can measure the firing force applied to a closure member coupledto a clamp arm of the surgical instrument or tool or the force appliedby a clamp arm to tissue located in the jaws of an ultrasonic orelectrosurgical instrument. Alternatively, a current sensor 478 can beemployed to measure the current drawn by the motor 482. The displacementmember also may be configured to engage a clamp arm to open or close theclamp arm. The force sensor may be configured to measure the clampingforce on tissue. The force required to advance the displacement membercan correspond to the current drawn by the motor 482, for example. Themeasured force is converted to a digital signal and provided to theprocessor 462.

In one form, the strain gauge sensor 474 can be used to measure theforce applied to the tissue by the end effector. A strain gauge can becoupled to the end effector to measure the force on the tissue beingtreated by the end effector. A system for measuring forces applied tothe tissue grasped by the end effector comprises a strain gauge sensor474, such as, for example, a micro-strain gauge, that is configured tomeasure one or more parameters of the end effector, for example. In oneaspect, the strain gauge sensor 474 can measure the amplitude ormagnitude of the strain exerted on a jaw member of an end effectorduring a clamping operation, which can be indicative of the tissuecompression. The measured strain is converted to a digital signal andprovided to a processor 462 of the microcontroller 461. A load sensor476 can measure the force used to operate the knife element, forexample, to cut the tissue captured between the anvil and the staplecartridge. A load sensor 476 can measure the force used to operate theclamp arm element, for example, to capture tissue between the clamp armand an ultrasonic blade or to capture tissue between the clamp arm and ajaw of an electrosurgical instrument. A magnetic field sensor can beemployed to measure the thickness of the captured tissue. Themeasurement of the magnetic field sensor also may be converted to adigital signal and provided to the processor 462.

The measurements of the tissue compression, the tissue thickness, and/orthe force required to close the end effector on the tissue, asrespectively measured by the sensors 474, 476, can be used by themicrocontroller 461 to characterize the selected position of the firingmember and/or the corresponding value of the speed of the firing member.In one instance, a memory 468 may store a technique, an equation, and/ora lookup table which can be employed by the microcontroller 461 in theassessment.

The control system 470 of the surgical instrument or tool also maycomprise wired or wireless communication circuits to communicate withthe modular communication hub as shown in FIGS. 8-11 .

FIG. 13 illustrates a control circuit 500 configured to control aspectsof the surgical instrument or tool according to one aspect of thisdisclosure. The control circuit 500 can be configured to implementvarious processes described herein. The control circuit 500 may comprisea microcontroller comprising one or more processors 502 (e.g.,microprocessor, microcontroller) coupled to at least one memory circuit504. The memory circuit 504 stores machine-executable instructions that,when executed by the processor 502, cause the processor 502 to executemachine instructions to implement various processes described herein.The processor 502 may be any one of a number of single-core or multicoreprocessors known in the art. The memory circuit 504 may comprisevolatile and non-volatile storage media. The processor 502 may includean instruction processing unit 506 and an arithmetic unit 508. Theinstruction processing unit may be configured to receive instructionsfrom the memory circuit 504 of this disclosure.

FIG. 14 illustrates a combinational logic circuit 510 configured tocontrol aspects of the surgical instrument or tool according to oneaspect of this disclosure. The combinational logic circuit 510 can beconfigured to implement various processes described herein. Thecombinational logic circuit 510 may comprise a finite state machinecomprising a combinational logic 512 configured to receive dataassociated with the surgical instrument or tool at an input 514, processthe data by the combinational logic 512, and provide an output 516.

FIG. 15 illustrates a sequential logic circuit 520 configured to controlaspects of the surgical instrument or tool according to one aspect ofthis disclosure. The sequential logic circuit 520 or the combinationallogic 522 can be configured to implement various processes describedherein. The sequential logic circuit 520 may comprise a finite statemachine. The sequential logic circuit 520 may comprise a combinationallogic 522, at least one memory circuit 524, and a clock 529, forexample. The at least one memory circuit 524 can store a current stateof the finite state machine. In certain instances, the sequential logiccircuit 520 may be synchronous or asynchronous. The combinational logic522 is configured to receive data associated with the surgicalinstrument or tool from an input 526, process the data by thecombinational logic 522, and provide an output 528. In other aspects,the circuit may comprise a combination of a processor (e.g., processor502, FIG. 13 ) and a finite state machine to implement various processesherein. In other aspects, the finite state machine may comprise acombination of a combinational logic circuit (e.g., combinational logiccircuit 510, FIG. 14 ) and the sequential logic circuit 520.

FIG. 16 illustrates a surgical instrument or tool comprising a pluralityof motors which can be activated to perform various functions. Incertain instances, a first motor can be activated to perform a firstfunction, a second motor can be activated to perform a second function,a third motor can be activated to perform a third function, a fourthmotor can be activated to perform a fourth function, and so on. Incertain instances, the plurality of motors of robotic surgicalinstrument 600 can be individually activated to cause firing, closure,and/or articulation motions in the end effector. The firing, closure,and/or articulation motions can be transmitted to the end effectorthrough a shaft assembly, for example.

In certain instances, the surgical instrument system or tool may includea firing motor 602. The firing motor 602 may be operably coupled to afiring motor drive assembly 604 which can be configured to transmitfiring motions, generated by the motor 602 to the end effector, inparticular to displace the clamp arm closure member. The closure membermay be retracted by reversing the direction of the motor 602, which alsocauses the clamp arm to open.

In certain instances, the surgical instrument or tool may include aclosure motor 603. The closure motor 603 may be operably coupled to aclosure motor drive assembly 605 which can be configured to transmitclosure motions, generated by the motor 603 to the end effector, inparticular to displace a closure tube to close the anvil and compresstissue between the anvil and the staple cartridge. The closure motor 603may be operably coupled to a closure motor drive assembly 605 which canbe configured to transmit closure motions, generated by the motor 603 tothe end effector, in particular to displace a closure tube to close theclamp arm and compress tissue between the clamp arm and either anultrasonic blade or jaw member of an electrosurgical device. The closuremotions may cause the end effector to transition from an openconfiguration to an approximated configuration to capture tissue, forexample. The end effector may be transitioned to an open position byreversing the direction of the motor 603.

In certain instances, the surgical instrument or tool may include one ormore articulation motors 606 a, 606 b, for example. The motors 606 a,606 b may be operably coupled to respective articulation motor driveassemblies 608 a, 608 b, which can be configured to transmitarticulation motions generated by the motors 606 a, 606 b to the endeffector. In certain instances, the articulation motions may cause theend effector to articulate relative to the shaft, for example.

As described above, the surgical instrument or tool may include aplurality of motors which may be configured to perform variousindependent functions. In certain instances, the plurality of motors ofthe surgical instrument or tool can be individually or separatelyactivated to perform one or more functions while the other motors remaininactive. For example, the articulation motors 606 a, 606 b can beactivated to cause the end effector to be articulated while the firingmotor 602 remains inactive. Alternatively, the firing motor 602 can beactivated to fire the plurality of staples, and/or to advance thecutting edge, while the articulation motor 606 remains inactive.Furthermore, the closure motor 603 may be activated simultaneously withthe firing motor 602 to cause the closure tube or closure member toadvance distally as described in more detail hereinbelow.

In certain instances, the surgical instrument or tool may include acommon control module 610 which can be employed with a plurality ofmotors of the surgical instrument or tool. In certain instances, thecommon control module 610 may accommodate one of the plurality of motorsat a time. For example, the common control module 610 can be couplableto and separable from the plurality of motors of the robotic surgicalinstrument individually. In certain instances, a plurality of the motorsof the surgical instrument or tool may share one or more common controlmodules such as the common control module 610. In certain instances, aplurality of motors of the surgical instrument or tool can beindividually and selectively engaged with the common control module 610.In certain instances, the common control module 610 can be selectivelyswitched from interfacing with one of a plurality of motors of thesurgical instrument or tool to interfacing with another one of theplurality of motors of the surgical instrument or tool.

In at least one example, the common control module 610 can beselectively switched between operable engagement with the articulationmotors 606 a, 606 b and operable engagement with either the firing motor602 or the closure motor 603. In at least one example, as illustrated inFIG. 16 , a switch 614 can be moved or transitioned between a pluralityof positions and/or states. In a first position 616, the switch 614 mayelectrically couple the common control module 610 to the firing motor602; in a second position 617, the switch 614 may electrically couplethe common control module 610 to the closure motor 603; in a thirdposition 618 a, the switch 614 may electrically couple the commoncontrol module 610 to the first articulation motor 606 a; and in afourth position 618 b, the switch 614 may electrically couple the commoncontrol module 610 to the second articulation motor 606 b, for example.In certain instances, separate common control modules 610 can beelectrically coupled to the firing motor 602, the closure motor 603, andthe articulations motor 606 a, 606 b at the same time. In certaininstances, the switch 614 may be a mechanical switch, anelectromechanical switch, a solid-state switch, or any suitableswitching mechanism.

Each of the motors 602, 603, 606 a, 606 b may comprise a torque sensorto measure the output torque on the shaft of the motor. The force on anend effector may be sensed in any conventional manner, such as by forcesensors on the outer sides of the jaws or by a torque sensor for themotor actuating the jaws.

In various instances, as illustrated in FIG. 16 , the common controlmodule 610 may comprise a motor driver 626 which may comprise one ormore H-Bridge FETs. The motor driver 626 may modulate the powertransmitted from a power source 628 to a motor coupled to the commoncontrol module 610 based on input from a microcontroller 620 (the“controller”), for example. In certain instances, the microcontroller620 can be employed to determine the current drawn by the motor, forexample, while the motor is coupled to the common control module 610, asdescribed above.

In certain instances, the microcontroller 620 may include amicroprocessor 622 (the “processor”) and one or more non-transitorycomputer-readable mediums or memory units 624 (the “memory”). In certaininstances, the memory 624 may store various program instructions, whichwhen executed may cause the processor 622 to perform a plurality offunctions and/or calculations described herein. In certain instances,one or more of the memory units 624 may be coupled to the processor 622,for example. In various aspects, the microcontroller 620 may communicateover a wired or wireless channel, or combinations thereof.

In certain instances, the power source 628 can be employed to supplypower to the microcontroller 620, for example. In certain instances, thepower source 628 may comprise a battery (or “battery pack” or “powerpack”), such as a lithium-ion battery, for example. In certaininstances, the battery pack may be configured to be releasably mountedto a handle for supplying power to the surgical instrument 600. A numberof battery cells connected in series may be used as the power source628. In certain instances, the power source 628 may be replaceableand/or rechargeable, for example.

In various instances, the processor 622 may control the motor driver 626to control the position, direction of rotation, and/or velocity of amotor that is coupled to the common control module 610. In certaininstances, the processor 622 can signal the motor driver 626 to stopand/or disable a motor that is coupled to the common control module 610.It should be understood that the term “processor” as used hereinincludes any suitable microprocessor, microcontroller, or other basiccomputing device that incorporates the functions of a computer's centralprocessing unit (CPU) on an integrated circuit or, at most, a fewintegrated circuits. The processor 622 is a multipurpose, programmabledevice that accepts digital data as input, processes it according toinstructions stored in its memory, and provides results as output. It isan example of sequential digital logic, as it has internal memory.Processors operate on numbers and symbols represented in the binarynumeral system.

In one instance, the processor 622 may be any single-core or multicoreprocessor such as those known under the trade name ARM Cortex by TexasInstruments. In certain instances, the microcontroller 620 may be an LM4F230H5QR, available from Texas Instruments, for example. In at leastone example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4FProcessor Core comprising an on-chip memory of 256 KB single-cycle flashmemory, or other non-volatile memory, up to 40 MHz, a prefetch buffer toimprove performance above 40 MHz, a 32 KB single-cycle SRAM, an internalROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWMmodules, one or more QEI analogs, one or more 12-bit ADCs with 12 analoginput channels, among other features that are readily available for theproduct datasheet. Other microcontrollers may be readily substituted foruse with the module 4410. Accordingly, the present disclosure should notbe limited in this context.

In certain instances, the memory 624 may include program instructionsfor controlling each of the motors of the surgical instrument 600 thatare couplable to the common control module 610. For example, the memory624 may include program instructions for controlling the firing motor602, the closure motor 603, and the articulation motors 606 a, 606 b.Such program instructions may cause the processor 622 to control thefiring, closure, and articulation functions in accordance with inputsfrom algorithms or control programs of the surgical instrument or tool.

In certain instances, one or more mechanisms and/or sensors such as, forexample, sensors 630 can be employed to alert the processor 622 to theprogram instructions that should be used in a particular setting. Forexample, the sensors 630 may alert the processor 622 to use the programinstructions associated with firing, closing, and articulating the endeffector. In certain instances, the sensors 630 may comprise positionsensors which can be employed to sense the position of the switch 614,for example. Accordingly, the processor 622 may use the programinstructions associated with firing the closure member coupled to theclamp arm of the end effector upon detecting, through the sensors 630for example, that the switch 614 is in the first position 616; theprocessor 622 may use the program instructions associated with closingthe anvil upon detecting, through the sensors 630 for example, that theswitch 614 is in the second position 617; and the processor 622 may usethe program instructions associated with articulating the end effectorupon detecting, through the sensors 630 for example, that the switch 614is in the third or fourth position 618 a, 618 b.

FIG. 17 is a schematic diagram of a robotic surgical instrument 700configured to operate a surgical tool described herein according to oneaspect of this disclosure. The robotic surgical instrument 700 may beprogrammed or configured to control distal/proximal translation of adisplacement member, distal/proximal displacement of a closure tube,shaft rotation, and articulation, either with single or multiplearticulation drive links. In one aspect, the surgical instrument 700 maybe programmed or configured to individually control a firing member, aclosure member, a shaft member, or one or more articulation members, orcombinations thereof. The surgical instrument 700 comprises a controlcircuit 710 configured to control motor-driven firing members, closuremembers, shaft members, or one or more articulation members, orcombinations thereof.

In one aspect, the robotic surgical instrument 700 comprises a controlcircuit 710 configured to control a clamp arm 716 and a closure member714 portion of an end effector 702, an ultrasonic blade 718 coupled toan ultrasonic transducer 719 excited by an ultrasonic generator 721, ashaft 740, and one or more articulation members 742 a, 742 b via aplurality of motors 704 a-704 e. A position sensor 734 may be configuredto provide position feedback of the closure member 714 to the controlcircuit 710. Other sensors 738 may be configured to provide feedback tothe control circuit 710. A timer/counter 731 provides timing andcounting information to the control circuit 710. An energy source 712may be provided to operate the motors 704 a-704 e, and a current sensor736 provides motor current feedback to the control circuit 710. Themotors 704 a-704 e can be operated individually by the control circuit710 in an open-loop or closed-loop feedback control.

In one aspect, the control circuit 710 may comprise one or moremicrocontrollers, microprocessors, or other suitable processors forexecuting instructions that cause the processor or processors to performone or more tasks. In one aspect, a timer/counter 731 provides an outputsignal, such as the elapsed time or a digital count, to the controlcircuit 710 to correlate the position of the closure member 714 asdetermined by the position sensor 734 with the output of thetimer/counter 731 such that the control circuit 710 can determine theposition of the closure member 714 at a specific time (t) relative to astarting position or the time (t) when the closure member 714 is at aspecific position relative to a starting position. The timer/counter 731may be configured to measure elapsed time, count external events, ortime external events.

In one aspect, the control circuit 710 may be programmed to controlfunctions of the end effector 702 based on one or more tissueconditions. The control circuit 710 may be programmed to sense tissueconditions, such as thickness, either directly or indirectly, asdescribed herein. The control circuit 710 may be programmed to select afiring control program or closure control program based on tissueconditions. A firing control program may describe the distal motion ofthe displacement member. Different firing control programs may beselected to better treat different tissue conditions. For example, whenthicker tissue is present, the control circuit 710 may be programmed totranslate the displacement member at a lower velocity and/or with lowerpower. When thinner tissue is present, the control circuit 710 may beprogrammed to translate the displacement member at a higher velocityand/or with higher power. A closure control program may control theclosure force applied to the tissue by the clamp arm 716. Other controlprograms control the rotation of the shaft 740 and the articulationmembers 742 a, 742 b.

In one aspect, the control circuit 710 may generate motor set pointsignals. The motor set point signals may be provided to various motorcontrollers 708 a-708 e. The motor controllers 708 a-708 e may compriseone or more circuits configured to provide motor drive signals to themotors 704 a-704 e to drive the motors 704 a-704 e as described herein.In some examples, the motors 704 a-704 e may be brushed DC electricmotors. For example, the velocity of the motors 704 a-704 e may beproportional to the respective motor drive signals. In some examples,the motors 704 a-704 e may be brushless DC electric motors, and therespective motor drive signals may comprise a PWM signal provided to oneor more stator windings of the motors 704 a-704 e. Also, in someexamples, the motor controllers 708 a-708 e may be omitted and thecontrol circuit 710 may generate the motor drive signals directly.

In one aspect, the control circuit 710 may initially operate each of themotors 704 a-704 e in an open-loop configuration for a first open-loopportion of a stroke of the displacement member. Based on the response ofthe robotic surgical instrument 700 during the open-loop portion of thestroke, the control circuit 710 may select a firing control program in aclosed-loop configuration. The response of the instrument may include atranslation distance of the displacement member during the open-loopportion, a time elapsed during the open-loop portion, the energyprovided to one of the motors 704 a-704 e during the open-loop portion,a sum of pulse widths of a motor drive signal, etc. After the open-loopportion, the control circuit 710 may implement the selected firingcontrol program for a second portion of the displacement member stroke.For example, during a closed-loop portion of the stroke, the controlcircuit 710 may modulate one of the motors 704 a-704 e based ontranslation data describing a position of the displacement member in aclosed-loop manner to translate the displacement member at a constantvelocity.

In one aspect, the motors 704 a-704 e may receive power from an energysource 712. The energy source 712 may be a DC power supply driven by amain alternating current power source, a battery, a super capacitor, orany other suitable energy source. The motors 704 a-704 e may bemechanically coupled to individual movable mechanical elements such asthe closure member 714, clamp arm 716, shaft 740, articulation 742 a,and articulation 742 b via respective transmissions 706 a-706 e. Thetransmissions 706 a-706 e may include one or more gears or other linkagecomponents to couple the motors 704 a-704 e to movable mechanicalelements. A position sensor 734 may sense a position of the closuremember 714. The position sensor 734 may be or include any type of sensorthat is capable of generating position data that indicate a position ofthe closure member 714. In some examples, the position sensor 734 mayinclude an encoder configured to provide a series of pulses to thecontrol circuit 710 as the closure member 714 translates distally andproximally. The control circuit 710 may track the pulses to determinethe position of the closure member 714. Other suitable position sensorsmay be used, including, for example, a proximity sensor. Other types ofposition sensors may provide other signals indicating motion of theclosure member 714. Also, in some examples, the position sensor 734 maybe omitted. Where any of the motors 704 a-704 e is a stepper motor, thecontrol circuit 710 may track the position of the closure member 714 byaggregating the number and direction of steps that the motor 704 hasbeen instructed to execute. The position sensor 734 may be located inthe end effector 702 or at any other portion of the instrument. Theoutputs of each of the motors 704 a-704 e include a torque sensor 744a-744 e to sense force and have an encoder to sense rotation of thedrive shaft.

In one aspect, the control circuit 710 is configured to drive a firingmember such as the closure member 714 portion of the end effector 702.The control circuit 710 provides a motor set point to a motor control708 a, which provides a drive signal to the motor 704 a. The outputshaft of the motor 704 a is coupled to a torque sensor 744 a. The torquesensor 744 a is coupled to a transmission 706 a which is coupled to theclosure member 714. The transmission 706 a comprises movable mechanicalelements such as rotating elements and a firing member to control themovement of the closure member 714 distally and proximally along alongitudinal axis of the end effector 702. In one aspect, the motor 704a may be coupled to the knife gear assembly, which includes a knife gearreduction set that includes a first knife drive gear and a second knifedrive gear. A torque sensor 744 a provides a firing force feedbacksignal to the control circuit 710. The firing force signal representsthe force required to fire or displace the closure member 714. Aposition sensor 734 may be configured to provide the position of theclosure member 714 along the firing stroke or the position of the firingmember as a feedback signal to the control circuit 710. The end effector702 may include additional sensors 738 configured to provide feedbacksignals to the control circuit 710. When ready to use, the controlcircuit 710 may provide a firing signal to the motor control 708 a. Inresponse to the firing signal, the motor 704 a may drive the firingmember distally along the longitudinal axis of the end effector 702 froma proximal stroke start position to a stroke end position distal to thestroke start position. As the closure member 714 translates distally,the clamp arm 716 closes towards the ultrasonic blade 718.

In one aspect, the control circuit 710 is configured to drive a closuremember such as the clamp arm 716 portion of the end effector 702. Thecontrol circuit 710 provides a motor set point to a motor control 708 b,which provides a drive signal to the motor 704 b. The output shaft ofthe motor 704 b is coupled to a torque sensor 744 b. The torque sensor744 b is coupled to a transmission 706 b which is coupled to the clamparm 716. The transmission 706 b comprises movable mechanical elementssuch as rotating elements and a closure member to control the movementof the clamp arm 716 from the open and closed positions. In one aspect,the motor 704 b is coupled to a closure gear assembly, which includes aclosure reduction gear set that is supported in meshing engagement withthe closure spur gear. The torque sensor 744 b provides a closure forcefeedback signal to the control circuit 710. The closure force feedbacksignal represents the closure force applied to the clamp arm 716. Theposition sensor 734 may be configured to provide the position of theclosure member as a feedback signal to the control circuit 710.Additional sensors 738 in the end effector 702 may provide the closureforce feedback signal to the control circuit 710. The pivotable clamparm 716 is positioned opposite the ultrasonic blade 718. When ready touse, the control circuit 710 may provide a closure signal to the motorcontrol 708 b. In response to the closure signal, the motor 704 badvances a closure member to grasp tissue between the clamp arm 716 andthe ultrasonic blade 718.

In one aspect, the control circuit 710 is configured to rotate a shaftmember such as the shaft 740 to rotate the end effector 702. The controlcircuit 710 provides a motor set point to a motor control 708 c, whichprovides a drive signal to the motor 704 c. The output shaft of themotor 704 c is coupled to a torque sensor 744 c. The torque sensor 744 cis coupled to a transmission 706 c which is coupled to the shaft 740.The transmission 706 c comprises movable mechanical elements such asrotating elements to control the rotation of the shaft 740 clockwise orcounterclockwise up to and over 360°. In one aspect, the motor 704 c iscoupled to the rotational transmission assembly, which includes a tubegear segment that is formed on (or attached to) the proximal end of theproximal closure tube for operable engagement by a rotational gearassembly that is operably supported on the tool mounting plate. Thetorque sensor 744 c provides a rotation force feedback signal to thecontrol circuit 710. The rotation force feedback signal represents therotation force applied to the shaft 740. The position sensor 734 may beconfigured to provide the position of the closure member as a feedbacksignal to the control circuit 710. Additional sensors 738 such as ashaft encoder may provide the rotational position of the shaft 740 tothe control circuit 710.

In one aspect, the control circuit 710 is configured to articulate theend effector 702. The control circuit 710 provides a motor set point toa motor control 708 d, which provides a drive signal to the motor 704 d.The output shaft of the motor 704 d is coupled to a torque sensor 744 d.The torque sensor 744 d is coupled to a transmission 706 d which iscoupled to an articulation member 742 a. The transmission 706 dcomprises movable mechanical elements such as articulation elements tocontrol the articulation of the end effector 702 ±65°. In one aspect,the motor 704 d is coupled to an articulation nut, which is rotatablyjournaled on the proximal end portion of the distal spine portion and isrotatably driven thereon by an articulation gear assembly. The torquesensor 744 d provides an articulation force feedback signal to thecontrol circuit 710. The articulation force feedback signal representsthe articulation force applied to the end effector 702. Sensors 738,such as an articulation encoder, may provide the articulation positionof the end effector 702 to the control circuit 710.

In another aspect, the articulation function of the robotic surgicalsystem 700 may comprise two articulation members, or links, 742 a, 742b. These articulation members 742 a, 742 b are driven by separate diskson the robot interface (the rack) which are driven by the two motors 708d, 708 e. When the separate firing motor 704 a is provided, each ofarticulation links 742 a, 742 b can be antagonistically driven withrespect to the other link in order to provide a resistive holding motionand a load to the head when it is not moving and to provide anarticulation motion as the head is articulated. The articulation members742 a, 742 b attach to the head at a fixed radius as the head isrotated. Accordingly, the mechanical advantage of the push-and-pull linkchanges as the head is rotated. This change in the mechanical advantagemay be more pronounced with other articulation link drive systems.

In one aspect, the one or more motors 704 a-704 e may comprise a brushedDC motor with a gearbox and mechanical links to a firing member, closuremember, or articulation member. Another example includes electric motors704 a-704 e that operate the movable mechanical elements such as thedisplacement member, articulation links, closure tube, and shaft. Anoutside influence is an unmeasured, unpredictable influence of thingslike tissue, surrounding bodies, and friction on the physical system.Such outside influence can be referred to as drag, which acts inopposition to one of electric motors 704 a-704 e. The outside influence,such as drag, may cause the operation of the physical system to deviatefrom a desired operation of the physical system.

In one aspect, the position sensor 734 may be implemented as an absolutepositioning system. In one aspect, the position sensor 734 may comprisea magnetic rotary absolute positioning system implemented as anAS5055EQFT single-chip magnetic rotary position sensor available fromAustria Microsystems, AG. The position sensor 734 may interface with thecontrol circuit 710 to provide an absolute positioning system. Theposition may include multiple Hall-effect elements located above amagnet and coupled to a CORDIC processor, also known as thedigit-by-digit method and Volder's algorithm, that is provided toimplement a simple and efficient algorithm to calculate hyperbolic andtrigonometric functions that require only addition, subtraction,bitshift, and table lookup operations.

In one aspect, the control circuit 710 may be in communication with oneor more sensors 738. The sensors 738 may be positioned on the endeffector 702 and adapted to operate with the robotic surgical instrument700 to measure the various derived parameters such as the gap distanceversus time, tissue compression versus time, and anvil strain versustime. The sensors 738 may comprise a magnetic sensor, a magnetic fieldsensor, a strain gauge, a load cell, a pressure sensor, a force sensor,a torque sensor, an inductive sensor such as an eddy current sensor, aresistive sensor, a capacitive sensor, an optical sensor, and/or anyother suitable sensor for measuring one or more parameters of the endeffector 702. The sensors 738 may include one or more sensors. Thesensors 738 may be located on the clamp arm 716 to determine tissuelocation using segmented electrodes. The torque sensors 744 a-744 e maybe configured to sense force such as firing force, closure force, and/orarticulation force, among others. Accordingly, the control circuit 710can sense (1) the closure load experienced by the distal closure tubeand its position, (2) the firing member at the rack and its position,(3) what portion of the ultrasonic blade 718 has tissue on it, and (4)the load and position on both articulation rods.

In one aspect, the one or more sensors 738 may comprise a strain gauge,such as a micro-strain gauge, configured to measure the magnitude of thestrain in the clamp arm 716 during a clamped condition. The strain gaugeprovides an electrical signal whose amplitude varies with the magnitudeof the strain. The sensors 738 may comprise a pressure sensor configuredto detect a pressure generated by the presence of compressed tissuebetween the clamp arm 716 and the ultrasonic blade 718. The sensors 738may be configured to detect impedance of a tissue section locatedbetween the clamp arm 716 and the ultrasonic blade 718 that isindicative of the thickness and/or fullness of tissue locatedtherebetween.

In one aspect, the sensors 738 may be implemented as one or more limitswitches, electromechanical devices, solid-state switches, Hall-effectdevices, magneto-resistive (MR) devices, giant magneto-resistive (GMR)devices, magnetometers, among others. In other implementations, thesensors 738 may be implemented as solid-state switches that operateunder the influence of light, such as optical sensors, IR sensors,ultraviolet sensors, among others. Still, the switches may besolid-state devices such as transistors (e.g., FET, junction FET,MOSFET, bipolar, and the like). In other implementations, the sensors738 may include electrical conductorless switches, ultrasonic switches,accelerometers, and inertial sensors, among others.

In one aspect, the sensors 738 may be configured to measure forcesexerted on the clamp arm 716 by the closure drive system. For example,one or more sensors 738 can be at an interaction point between theclosure tube and the clamp arm 716 to detect the closure forces appliedby the closure tube to the clamp arm 716. The forces exerted on theclamp arm 716 can be representative of the tissue compressionexperienced by the tissue section captured between the clamp arm 716 andthe ultrasonic blade 718. The one or more sensors 738 can be positionedat various interaction points along the closure drive system to detectthe closure forces applied to the clamp arm 716 by the closure drivesystem. The one or more sensors 738 may be sampled in real time during aclamping operation by the processor of the control circuit 710. Thecontrol circuit 710 receives real-time sample measurements to provideand analyze time-based information and assess, in real time, closureforces applied to the clamp arm 716.

In one aspect, a current sensor 736 can be employed to measure thecurrent drawn by each of the motors 704 a-704 e. The force required toadvance any of the movable mechanical elements such as the closuremember 714 corresponds to the current drawn by one of the motors 704a-704 e. The force is converted to a digital signal and provided to thecontrol circuit 710. The control circuit 710 can be configured tosimulate the response of the actual system of the instrument in thesoftware of the controller. A displacement member can be actuated tomove the closure member 714 in the end effector 702 at or near a targetvelocity. The robotic surgical instrument 700 can include a feedbackcontroller, which can be one of any feedback controllers, including, butnot limited to a PID, a state feedback, a linear-quadratic (LQR), and/oran adaptive controller, for example. The robotic surgical instrument 700can include a power source to convert the signal from the feedbackcontroller into a physical input such as case voltage, PWM voltage,frequency modulated voltage, current, torque, and/or force, for example.Additional details are disclosed in U.S. patent application Ser. No.15/636,829, titled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTICSURGICAL INSTRUMENT, filed Jun. 29, 2017, which is herein incorporatedby reference in its entirety.

FIG. 18 illustrates a schematic diagram of a surgical instrument 750configured to control the distal translation of a displacement memberaccording to one aspect of this disclosure. In one aspect, the surgicalinstrument 750 is programmed to control the distal translation of adisplacement member such as the closure member 764. The surgicalinstrument 750 comprises an end effector 752 that may comprise a clamparm 766, a closure member 764, and an ultrasonic blade 768 coupled to anultrasonic transducer 769 driven by an ultrasonic generator 771.

The position, movement, displacement, and/or translation of a lineardisplacement member, such as the closure member 764, can be measured byan absolute positioning system, sensor arrangement, and position sensor784. Because the closure member 764 is coupled to a longitudinallymovable drive member, the position of the closure member 764 can bedetermined by measuring the position of the longitudinally movable drivemember employing the position sensor 784. Accordingly, in the followingdescription, the position, displacement, and/or translation of theclosure member 764 can be achieved by the position sensor 784 asdescribed herein. A control circuit 760 may be programmed to control thetranslation of the displacement member, such as the closure member 764.The control circuit 760, in some examples, may comprise one or moremicrocontrollers, microprocessors, or other suitable processors forexecuting instructions that cause the processor or processors to controlthe displacement member, e.g., the closure member 764, in the mannerdescribed. In one aspect, a timer/counter 781 provides an output signal,such as the elapsed time or a digital count, to the control circuit 760to correlate the position of the closure member 764 as determined by theposition sensor 784 with the output of the timer/counter 781 such thatthe control circuit 760 can determine the position of the closure member764 at a specific time (t) relative to a starting position. Thetimer/counter 781 may be configured to measure elapsed time, countexternal events, or time external events.

The control circuit 760 may generate a motor set point signal 772. Themotor set point signal 772 may be provided to a motor controller 758.The motor controller 758 may comprise one or more circuits configured toprovide a motor drive signal 774 to the motor 754 to drive the motor 754as described herein. In some examples, the motor 754 may be a brushed DCelectric motor. For example, the velocity of the motor 754 may beproportional to the motor drive signal 774. In some examples, the motor754 may be a brushless DC electric motor and the motor drive signal 774may comprise a PWM signal provided to one or more stator windings of themotor 754. Also, in some examples, the motor controller 758 may beomitted, and the control circuit 760 may generate the motor drive signal774 directly.

The motor 754 may receive power from an energy source 762. The energysource 762 may be or include a battery, a super capacitor, or any othersuitable energy source. The motor 754 may be mechanically coupled to theclosure member 764 via a transmission 756. The transmission 756 mayinclude one or more gears or other linkage components to couple themotor 754 to the closure member 764. A position sensor 784 may sense aposition of the closure member 764. The position sensor 784 may be orinclude any type of sensor that is capable of generating position datathat indicate a position of the closure member 764. In some examples,the position sensor 784 may include an encoder configured to provide aseries of pulses to the control circuit 760 as the closure member 764translates distally and proximally. The control circuit 760 may trackthe pulses to determine the position of the closure member 764. Othersuitable position sensors may be used, including, for example, aproximity sensor. Other types of position sensors may provide othersignals indicating motion of the closure member 764. Also, in someexamples, the position sensor 784 may be omitted. Where the motor 754 isa stepper motor, the control circuit 760 may track the position of theclosure member 764 by aggregating the number and direction of steps thatthe motor 754 has been instructed to execute. The position sensor 784may be located in the end effector 752 or at any other portion of theinstrument.

The control circuit 760 may be in communication with one or more sensors788. The sensors 788 may be positioned on the end effector 752 andadapted to operate with the surgical instrument 750 to measure thevarious derived parameters such as gap distance versus time, tissuecompression versus time, and anvil strain versus time. The sensors 788may comprise a magnetic sensor, a magnetic field sensor, a strain gauge,a pressure sensor, a force sensor, an inductive sensor such as an eddycurrent sensor, a resistive sensor, a capacitive sensor, an opticalsensor, and/or any other suitable sensor for measuring one or moreparameters of the end effector 752. The sensors 788 may include one ormore sensors.

The one or more sensors 788 may comprise a strain gauge, such as amicro-strain gauge, configured to measure the magnitude of the strain inthe clamp arm 766 during a clamped condition. The strain gauge providesan electrical signal whose amplitude varies with the magnitude of thestrain. The sensors 788 may comprise a pressure sensor configured todetect a pressure generated by the presence of compressed tissue betweenthe clamp arm 766 and the ultrasonic blade 768. The sensors 788 may beconfigured to detect impedance of a tissue section located between theclamp arm 766 and the ultrasonic blade 768 that is indicative of thethickness and/or fullness of tissue located therebetween.

The sensors 788 may be is configured to measure forces exerted on theclamp arm 766 by a closure drive system. For example, one or moresensors 788 can be at an interaction point between a closure tube andthe clamp arm 766 to detect the closure forces applied by a closure tubeto the clamp arm 766. The forces exerted on the clamp arm 766 can berepresentative of the tissue compression experienced by the tissuesection captured between the clamp arm 766 and the ultrasonic blade 768.The one or more sensors 788 can be positioned at various interactionpoints along the closure drive system to detect the closure forcesapplied to the clamp arm 766 by the closure drive system. The one ormore sensors 788 may be sampled in real time during a clamping operationby a processor of the control circuit 760. The control circuit 760receives real-time sample measurements to provide and analyze time-basedinformation and assess, in real time, closure forces applied to theclamp arm 766.

A current sensor 786 can be employed to measure the current drawn by themotor 754. The force required to advance the closure member 764corresponds to the current drawn by the motor 754. The force isconverted to a digital signal and provided to the control circuit 760.

The control circuit 760 can be configured to simulate the response ofthe actual system of the instrument in the software of the controller. Adisplacement member can be actuated to move a closure member 764 in theend effector 752 at or near a target velocity. The surgical instrument750 can include a feedback controller, which can be one of any feedbackcontrollers, including, but not limited to a PID, a state feedback, LQR,and/or an adaptive controller, for example. The surgical instrument 750can include a power source to convert the signal from the feedbackcontroller into a physical input such as case voltage, PWM voltage,frequency modulated voltage, current, torque, and/or force, for example.

The actual drive system of the surgical instrument 750 is configured todrive the displacement member, cutting member, or closure member 764, bya brushed DC motor with gearbox and mechanical links to an articulationand/or knife system. Another example is the electric motor 754 thatoperates the displacement member and the articulation driver, forexample, of an interchangeable shaft assembly. An outside influence isan unmeasured, unpredictable influence of things like tissue,surrounding bodies and friction on the physical system. Such outsideinfluence can be referred to as drag which acts in opposition to theelectric motor 754. The outside influence, such as drag, may cause theoperation of the physical system to deviate from a desired operation ofthe physical system.

Various example aspects are directed to a surgical instrument 750comprising an end effector 752 with motor-driven surgical sealing andcutting implements. For example, a motor 754 may drive a displacementmember distally and proximally along a longitudinal axis of the endeffector 752. The end effector 752 may comprise a pivotable clamp arm766 and, when configured for use, an ultrasonic blade 768 positionedopposite the clamp arm 766. A clinician may grasp tissue between theclamp arm 766 and the ultrasonic blade 768, as described herein. Whenready to use the instrument 750, the clinician may provide a firingsignal, for example by depressing a trigger of the instrument 750. Inresponse to the firing signal, the motor 754 may drive the displacementmember distally along the longitudinal axis of the end effector 752 froma proximal stroke begin position to a stroke end position distal of thestroke begin position. As the displacement member translates distally,the closure member 764 with a cutting element positioned at a distalend, may cut the tissue between the ultrasonic blade 768 and the clamparm 766.

In various examples, the surgical instrument 750 may comprise a controlcircuit 760 programmed to control the distal translation of thedisplacement member, such as the closure member 764, for example, basedon one or more tissue conditions. The control circuit 760 may beprogrammed to sense tissue conditions, such as thickness, eitherdirectly or indirectly, as described herein. The control circuit 760 maybe programmed to select a control program based on tissue conditions. Acontrol program may describe the distal motion of the displacementmember. Different control programs may be selected to better treatdifferent tissue conditions. For example, when thicker tissue ispresent, the control circuit 760 may be programmed to translate thedisplacement member at a lower velocity and/or with lower power. Whenthinner tissue is present, the control circuit 760 may be programmed totranslate the displacement member at a higher velocity and/or withhigher power.

In some examples, the control circuit 760 may initially operate themotor 754 in an open loop configuration for a first open loop portion ofa stroke of the displacement member. Based on a response of theinstrument 750 during the open loop portion of the stroke, the controlcircuit 760 may select a firing control program. The response of theinstrument may include, a translation distance of the displacementmember during the open loop portion, a time elapsed during the open loopportion, energy provided to the motor 754 during the open loop portion,a sum of pulse widths of a motor drive signal, etc. After the open loopportion, the control circuit 760 may implement the selected firingcontrol program for a second portion of the displacement member stroke.For example, during the closed loop portion of the stroke, the controlcircuit 760 may modulate the motor 754 based on translation datadescribing a position of the displacement member in a closed loop mannerto translate the displacement member at a constant velocity. Additionaldetails are disclosed in U.S. patent application Ser. No. 15/720,852,titled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICALINSTRUMENT, filed Sep. 29, 2017, which is herein incorporated byreference in its entirety.

FIG. 19 is a schematic diagram of a surgical instrument 790 configuredto control various functions according to one aspect of this disclosure.In one aspect, the surgical instrument 790 is programmed to controldistal translation of a displacement member such as the closure member764. The surgical instrument 790 comprises an end effector 792 that maycomprise a clamp arm 766, a closure member 764, and an ultrasonic blade768 which may be interchanged with or work in conjunction with one ormore RF electrodes 796 (shown in dashed line). The ultrasonic blade 768is coupled to an ultrasonic transducer 769 driven by an ultrasonicgenerator 771.

In one aspect, sensors 788 may be implemented as a limit switch,electromechanical device, solid-state switches, Hall-effect devices, MRdevices, GMR devices, magnetometers, among others. In otherimplementations, the sensors 638 may be solid-state switches thatoperate under the influence of light, such as optical sensors, IRsensors, ultraviolet sensors, among others. Still, the switches may besolid-state devices such as transistors (e.g., FET, junction FET,MOSFET, bipolar, and the like). In other implementations, the sensors788 may include electrical conductorless switches, ultrasonic switches,accelerometers, and inertial sensors, among others.

In one aspect, the position sensor 784 may be implemented as an absolutepositioning system comprising a magnetic rotary absolute positioningsystem implemented as an AS5055EQFT single-chip magnetic rotary positionsensor available from Austria Microsystems, AG. The position sensor 784may interface with the control circuit 760 to provide an absolutepositioning system. The position may include multiple Hall-effectelements located above a magnet and coupled to a CORDIC processor, alsoknown as the digit-by-digit method and Volder's algorithm, that isprovided to implement a simple and efficient algorithm to calculatehyperbolic and trigonometric functions that require only addition,subtraction, bitshift, and table lookup operations.

In some examples, the position sensor 784 may be omitted. Where themotor 754 is a stepper motor, the control circuit 760 may track theposition of the closure member 764 by aggregating the number anddirection of steps that the motor has been instructed to execute. Theposition sensor 784 may be located in the end effector 792 or at anyother portion of the instrument.

The control circuit 760 may be in communication with one or more sensors788. The sensors 788 may be positioned on the end effector 792 andadapted to operate with the surgical instrument 790 to measure thevarious derived parameters such as gap distance versus time, tissuecompression versus time, and anvil strain versus time. The sensors 788may comprise a magnetic sensor, a magnetic field sensor, a strain gauge,a pressure sensor, a force sensor, an inductive sensor such as an eddycurrent sensor, a resistive sensor, a capacitive sensor, an opticalsensor, and/or any other suitable sensor for measuring one or moreparameters of the end effector 792. The sensors 788 may include one ormore sensors.

An RF energy source 794 is coupled to the end effector 792 and isapplied to the RF electrode 796 when the RF electrode 796 is provided inthe end effector 792 in place of the ultrasonic blade 768 or to work inconjunction with the ultrasonic blade 768. For example, the ultrasonicblade is made of electrically conductive metal and may be employed asthe return path for electrosurgical RF current. The control circuit 760controls the delivery of the RF energy to the RF electrode 796.

Additional details are disclosed in U.S. patent application Ser. No.15/636,096, titled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE ANDRADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed Jun. 28,2017, which is herein incorporated by reference in its entirety.

Generator Hardware

In various aspects smart ultrasonic energy devices may comprise adaptivealgorithms to control the operation of the ultrasonic blade. In oneaspect, the ultrasonic blade adaptive control algorithms are configuredto identify tissue type and adjust device parameters. In one aspect, theultrasonic blade control algorithms are configured to parameterizetissue type. An algorithm to detect the collagen/elastic ratio of tissueto tune the amplitude of the distal tip of the ultrasonic blade isdescribed in the following section of the present disclosure. Variousaspects of smart ultrasonic energy devices are described herein inconnection with FIGS. 12-19 , for example. Accordingly, the followingdescription of adaptive ultrasonic blade control algorithms should beread in conjunction with FIGS. 12-19 and the description associatedtherewith.

In certain surgical procedures it would be desirable to employ adaptiveultrasonic blade control algorithms. In one aspect, adaptive ultrasonicblade control algorithms may be employed to adjust the parameters of theultrasonic device based on the type of tissue in contact with theultrasonic blade. In one aspect, the parameters of the ultrasonic devicemay be adjusted based on the location of the tissue within the jaws ofthe ultrasonic end effector, for example, the location of the tissuebetween the clamp arm and the ultrasonic blade. The impedance of theultrasonic transducer may be employed to differentiate what percentageof the tissue is located in the distal or proximal end of the endeffector. The reactions of the ultrasonic device may be based on thetissue type or compressibility of the tissue. In another aspect, theparameters of the ultrasonic device may be adjusted based on theidentified tissue type or parameterization. For example, the mechanicaldisplacement amplitude of the distal tip of the ultrasonic blade may betuned based on the ration of collagen to elastin tissue detected duringthe tissue identification procedure. The ratio of collagen to elastintissue may be detected used a variety of techniques including infrared(IR) surface reflectance and emissivity. The force applied to the tissueby the clamp arm and/or the stroke of the clamp arm to produce gap andcompression. Electrical continuity across a jaw equipped with electrodesmay be employed to determine what percentage of the jaw is covered withtissue.

FIG. 20 is a system 800 configured to execute adaptive ultrasonic bladecontrol algorithms in a surgical data network comprising a modularcommunication hub, in accordance with at least one aspect of the presentdisclosure. In one aspect, the generator module 240 is configured toexecute the adaptive ultrasonic blade control algorithm(s) 802. Inanother aspect, the device/instrument 235 is configured to execute theadaptive ultrasonic blade control algorithm(s) 804. In another aspect,both the generator module 240 and the device/instrument 235 areconfigured to execute the adaptive ultrasonic blade control algorithms802, 804.

The generator module 240 may comprise a patient isolated stage incommunication with a non-isolated stage via a power transformer. Asecondary winding of the power transformer is contained in the isolatedstage and may comprise a tapped configuration (e.g., a center-tapped ora non-center-tapped configuration) to define drive signal outputs fordelivering drive signals to different surgical instruments, such as, forexample, an ultrasonic surgical instrument, an RF electrosurgicalinstrument, and a multifunction surgical instrument which includesultrasonic and RF energy modes that can be delivered alone orsimultaneously. In particular, the drive signal outputs may output anultrasonic drive signal (e.g., a 420V root-mean-square (RMS) drivesignal) to an ultrasonic surgical instrument 241, and the drive signaloutputs may output an RF electrosurgical drive signal (e.g., a 100V RMSdrive signal) to an RF electrosurgical instrument 241. Aspects of thegenerator module 240 are described herein with reference to FIGS. 21-22.

The generator module 240 or the device/instrument 235 or both arecoupled the modular control tower 236 connected to multiple operatingtheater devices such as, for example, intelligent surgical instruments,robots, and other computerized devices located in the operating theater,as described with reference to FIGS. 8-11 , for example.

FIG. 21 illustrates an example of a generator 900, which is one form ofa generator configured to couple to an ultrasonic instrument and furtherconfigured to execute adaptive ultrasonic blade control algorithms in asurgical data network comprising a modular communication hub as shown inFIG. 20 . The generator 900 is configured to deliver multiple energymodalities to a surgical instrument. The generator 900 provides RF andultrasonic signals for delivering energy to a surgical instrument eitherindependently or simultaneously. The RF and ultrasonic signals may beprovided alone or in combination and may be provided simultaneously. Asnoted above, at least one generator output can deliver multiple energymodalities (e.g., ultrasonic, bipolar or monopolar RF, irreversibleand/or reversible electroporation, and/or microwave energy, amongothers) through a single port, and these signals can be deliveredseparately or simultaneously to the end effector to treat tissue. Thegenerator 900 comprises a processor 902 coupled to a waveform generator904. The processor 902 and waveform generator 904 are configured togenerate a variety of signal waveforms based on information stored in amemory coupled to the processor 902, not shown for clarity ofdisclosure. The digital information associated with a waveform isprovided to the waveform generator 904 which includes one or more DACcircuits to convert the digital input into an analog output. The analogoutput is fed to an amplifier 1106 for signal conditioning andamplification. The conditioned and amplified output of the amplifier 906is coupled to a power transformer 908. The signals are coupled acrossthe power transformer 908 to the secondary side, which is in the patientisolation side. A first signal of a first energy modality is provided tothe surgical instrument between the terminals labeled ENERGY₁ andRETURN. A second signal of a second energy modality is coupled across acapacitor 910 and is provided to the surgical instrument between theterminals labeled ENERGY₂ and RETURN. It will be appreciated that morethan two energy modalities may be output and thus the subscript “n” maybe used to designate that up to n ENERGY_(n) terminals may be provided,where n is a positive integer greater than 1. It also will beappreciated that up to “n” return paths RETURN_(n) may be providedwithout departing from the scope of the present disclosure.

A first voltage sensing circuit 912 is coupled across the terminalslabeled ENERGY₁ and the RETURN path to measure the output voltagetherebetween. A second voltage sensing circuit 924 is coupled across theterminals labeled ENERGY₂ and the RETURN path to measure the outputvoltage therebetween. A current sensing circuit 914 is disposed inseries with the RETURN leg of the secondary side of the powertransformer 908 as shown to measure the output current for either energymodality. If different return paths are provided for each energymodality, then a separate current sensing circuit should be provided ineach return leg. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to respective isolation transformers 916,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 918. The outputs of the isolationtransformers 916, 928, 922 in the on the primary side of the powertransformer 908 (non-patient isolated side) are provided to a one ormore ADC circuit 926. The digitized output of the ADC circuit 926 isprovided to the processor 902 for further processing and computation.The output voltages and output current feedback information can beemployed to adjust the output voltage and current provided to thesurgical instrument and to compute output impedance, among otherparameters. Input/output communications between the processor 902 andpatient isolated circuits is provided through an interface circuit 920.Sensors also may be in electrical communication with the processor 902by way of the interface circuit 920.

In one aspect, the impedance may be determined by the processor 902 bydividing the output of either the first voltage sensing circuit 912coupled across the terminals labeled ENERGY₁/RETURN or the secondvoltage sensing circuit 924 coupled across the terminals labeledENERGY₂/RETURN by the output of the current sensing circuit 914 disposedin series with the RETURN leg of the secondary side of the powertransformer 908. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to separate isolations transformers 916,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 916. The digitized voltage and currentsensing measurements from the ADC circuit 926 are provided the processor902 for computing impedance. As an example, the first energy modalityENERGY₁ may be ultrasonic energy and the second energy modality ENERGY₂may be RF energy. Nevertheless, in addition to ultrasonic and bipolar ormonopolar RF energy modalities, other energy modalities includeirreversible and/or reversible electroporation and/or microwave energy,among others. Also, although the example illustrated in FIG. 21 shows asingle return path RETURN may be provided for two or more energymodalities, in other aspects, multiple return paths RETURN_(n) may beprovided for each energy modality ENERGY_(n). Thus, as described herein,the ultrasonic transducer impedance may be measured by dividing theoutput of the first voltage sensing circuit 912 by the current sensingcircuit 914 and the tissue impedance may be measured by dividing theoutput of the second voltage sensing circuit 924 by the current sensingcircuit 914.

As shown in FIG. 21 , the generator 900 comprising at least one outputport can include a power transformer 908 with a single output and withmultiple taps to provide power in the form of one or more energymodalities, such as ultrasonic, bipolar or monopolar RF, irreversibleand/or reversible electroporation, and/or microwave energy, amongothers, for example, to the end effector depending on the type oftreatment of tissue being performed. For example, the generator 900 candeliver energy with higher voltage and lower current to drive anultrasonic transducer, with lower voltage and higher current to drive RFelectrodes for sealing tissue, or with a coagulation waveform for spotcoagulation using either monopolar or bipolar RF electrosurgicalelectrodes. The output waveform from the generator 900 can be steered,switched, or filtered to provide the frequency to the end effector ofthe surgical instrument. The connection of an ultrasonic transducer tothe generator 900 output would be preferably located between the outputlabeled ENERGY₁ and RETURN as shown in FIG. 21 . In one example, aconnection of RF bipolar electrodes to the generator 900 output would bepreferably located between the output labeled ENERGY₂ and RETURN. In thecase of monopolar output, the preferred connections would be activeelectrode (e.g., pencil or other probe) to the ENERGY₂ output and asuitable return pad connected to the RETURN output.

Additional details are disclosed in U.S. Patent Application PublicationNo. 2017/0086914, titled TECHNIQUES FOR OPERATING GENERATOR FORDIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS, which published on Mar. 30, 2017, which is hereinincorporated by reference in its entirety.

As used throughout this description, the term “wireless” and itsderivatives may be used to describe circuits, devices, systems, methods,techniques, communications channels, etc., that may communicate datathrough the use of modulated electromagnetic radiation through anon-solid medium. The term does not imply that the associated devices donot contain any wires, although in some aspects they might not. Thecommunication module may implement any of a number of wireless or wiredcommunication standards or protocols, including but not limited to Wi-Fi(IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long termevolution (LTE), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA,TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as anyother wireless and wired protocols that are designated as 3G, 4G, 5G,and beyond. The computing module may include a plurality ofcommunication modules. For instance, a first communication module may bededicated to shorter range wireless communications such as Wi-Fi andBluetooth and a second communication module may be dedicated to longerrange wireless communications such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE,Ev-DO, and others.

As used herein a processor or processing unit is an electronic circuitwhich performs operations on some external data source, usually memoryor some other data stream. The term is used herein to refer to thecentral processor (central processing unit) in a system or computersystems (especially systems on a chip (SoCs)) that combine a number ofspecialized “processors.”

As used herein, a system on a chip or system on chip (SoC or SOC) is anintegrated circuit (also known as an “IC” or “chip”) that integrates allcomponents of a computer or other electronic systems. It may containdigital, analog, mixed-signal, and often radio-frequency functions-allon a single substrate. A SoC integrates a microcontroller (ormicroprocessor) with advanced peripherals like graphics processing unit(GPU), Wi-Fi module, or coprocessor. A SoC may or may not containbuilt-in memory.

As used herein, a microcontroller or controller is a system thatintegrates a microprocessor with peripheral circuits and memory. Amicrocontroller (or MCU for microcontroller unit) may be implemented asa small computer on a single integrated circuit. It may be similar to aSoC; a SoC may include a microcontroller as one of its components. Amicrocontroller may contain one or more core processing units (CPUs)along with memory and programmable input/output peripherals. Programmemory in the form of Ferroelectric RAM, NOR flash or OTP ROM is alsooften included on chip, as well as a small amount of RAM.Microcontrollers may be employed for embedded applications, in contrastto the microprocessors used in personal computers or other generalpurpose applications consisting of various discrete chips.

As used herein, the term controller or microcontroller may be astand-alone IC or chip device that interfaces with a peripheral device.This may be a link between two parts of a computer or a controller on anexternal device that manages the operation of (and connection with) thatdevice.

Any of the processors or microcontrollers described herein, may beimplemented by any single core or multicore processor such as thoseknown under the trade name ARM Cortex by Texas Instruments. In oneaspect, the processor may be an LM4F230H5QR ARM Cortex-M4F ProcessorCore, available from Texas Instruments, for example, comprising on-chipmemory of 256 KB single-cycle flash memory, or other non-volatilememory, up to 40 MHz, a prefetch buffer to improve performance above 40MHz, a 32 KB single-cycle serial random access memory (SRAM), internalread-only memory (ROM) loaded with StellarisWare® software, 2 KBelectrically erasable programmable read-only memory (EEPROM), one ormore pulse width modulation (PWM) modules, one or more quadratureencoder inputs (QEI) analog, one or more 12-bit Analog-to-DigitalConverters (ADC) with 12 analog input channels, details of which areavailable for the product datasheet.

In one aspect, the processor may comprise a safety controller comprisingtwo controller-based families such as TMS570 and RM4x known under thetrade name Hercules ARM Cortex R4, also by Texas Instruments. The safetycontroller may be configured specifically for IEC 61508 and ISO 26262safety critical applications, among others, to provide advancedintegrated safety features while delivering scalable performance,connectivity, and memory options.

Modular devices include the modules (as described in connection withFIGS. 3 and 9 , for example) that are receivable within a surgical huband the surgical devices or instruments that can be connected to thevarious modules in order to connect or pair with the correspondingsurgical hub. The modular devices include, for example, intelligentsurgical instruments, medical imaging devices, suction/irrigationdevices, smoke evacuators, energy generators, ventilators, insufflators,and displays. The modular devices described herein can be controlled bycontrol algorithms. The control algorithms can be executed on themodular device itself, on the surgical hub to which the particularmodular device is paired, or on both the modular device and the surgicalhub (e.g., via a distributed computing architecture). In someexemplifications, the modular devices' control algorithms control thedevices based on data sensed by the modular device itself (i.e., bysensors in, on, or connected to the modular device). This data can berelated to the patient being operated on (e.g., tissue properties orinsufflation pressure) or the modular device itself (e.g., the rate atwhich a knife is being advanced, motor current, or energy levels). Forexample, a control algorithm for a surgical stapling and cuttinginstrument can control the rate at which the instrument's motor drivesits knife through tissue according to resistance encountered by theknife as it advances.

FIG. 22 illustrates one form of a surgical system 1000 comprising agenerator 1100 and various surgical instruments 1104, 1106, 1108 usabletherewith, where the surgical instrument 1104 is an ultrasonic surgicalinstrument, the surgical instrument 1106 is an RF electrosurgicalinstrument, and the multifunction surgical instrument 1108 is acombination ultrasonic/RF electrosurgical instrument. The generator 1100is configurable for use with a variety of surgical instruments.According to various forms, the generator 1100 may be configurable foruse with different surgical instruments of different types including,for example, ultrasonic surgical instruments 1104, RF electrosurgicalinstruments 1106, and multifunction surgical instruments 1108 thatintegrate RF and ultrasonic energies delivered simultaneously from thegenerator 1100. Although in the form of FIG. 22 the generator 1100 isshown separate from the surgical instruments 1104, 1106, 1108 in oneform, the generator 1100 may be formed integrally with any of thesurgical instruments 1104, 1106, 1108 to form a unitary surgical system.The generator 1100 comprises an input device 1110 located on a frontpanel of the generator 1100 console. The input device 1110 may compriseany suitable device that generates signals suitable for programming theoperation of the generator 1100. The generator 1100 may be configuredfor wired or wireless communication.

The generator 1100 is configured to drive multiple surgical instruments1104, 1106, 1108. The first surgical instrument is an ultrasonicsurgical instrument 1104 and comprises a handpiece 1105 (HP), anultrasonic transducer 1120, a shaft 1126, and an end effector 1122. Theend effector 1122 comprises an ultrasonic blade 1128 acousticallycoupled to the ultrasonic transducer 1120 and a clamp arm 1140. Thehandpiece 1105 comprises a trigger 1143 to operate the clamp arm 1140and a combination of the toggle buttons 1134 a, 1134 b, 1134 c toenergize and drive the ultrasonic blade 1128 or other function. Thetoggle buttons 1134 a, 1134 b, 1134 c can be configured to energize theultrasonic transducer 1120 with the generator 1100.

The generator 1100 also is configured to drive a second surgicalinstrument 1106. The second surgical instrument 1106 is an RFelectrosurgical instrument and comprises a handpiece 1107 (HP), a shaft1127, and an end effector 1124. The end effector 1124 compriseselectrodes in clamp arms 1142 a, 1142 b and return through an electricalconductor portion of the shaft 1127. The electrodes are coupled to andenergized by a bipolar energy source within the generator 1100. Thehandpiece 1107 comprises a trigger 1145 to operate the clamp arms 1142a, 1142 b and an energy button 1135 to actuate an energy switch toenergize the electrodes in the end effector 1124.

The generator 1100 also is configured to drive a multifunction surgicalinstrument 1108. The multifunction surgical instrument 1108 comprises ahandpiece 1109 (HP), a shaft 1129, and an end effector 1125. The endeffector 1125 comprises an ultrasonic blade 1149 and a clamp arm 1146.The ultrasonic blade 1149 is acoustically coupled to the ultrasonictransducer 1120. The handpiece 1109 comprises a trigger 1147 to operatethe clamp arm 1146 and a combination of the toggle buttons 1137 a, 1137b, 1137 c to energize and drive the ultrasonic blade 1149 or otherfunction. The toggle buttons 1137 a, 1137 b, 1137 c can be configured toenergize the ultrasonic transducer 1120 with the generator 1100 andenergize the ultrasonic blade 1149 with a bipolar energy source alsocontained within the generator 1100.

The generator 1100 is configurable for use with a variety of surgicalinstruments. According to various forms, the generator 1100 may beconfigurable for use with different surgical instruments of differenttypes including, for example, the ultrasonic surgical instrument 1104,the RF electrosurgical instrument 1106, and the multifunction surgicalinstrument 1108 that integrates RF and ultrasonic energies deliveredsimultaneously from the generator 1100. Although in the form of FIG. 22the generator 1100 is shown separate from the surgical instruments 1104,1106, 1108, in another form the generator 1100 may be formed integrallywith any one of the surgical instruments 1104, 1106, 1108 to form aunitary surgical system. As discussed above, the generator 1100comprises an input device 1110 located on a front panel of the generator1100 console. The input device 1110 may comprise any suitable devicethat generates signals suitable for programming the operation of thegenerator 1100. The generator 1100 also may comprise one or more outputdevices 1112. Further aspects of generators for digitally generatingelectrical signal waveforms and surgical instruments are described in USpatent publication US-2017-0086914-A1, which is herein incorporated byreference in its entirety.

Situational Awareness

Although an “intelligent” device including control algorithms thatrespond to sensed data can be an improvement over a “dumb” device thatoperates without accounting for sensed data, some sensed data can beincomplete or inconclusive when considered in isolation, i.e., withoutthe context of the type of surgical procedure being performed or thetype of tissue that is being operated on. Without knowing the proceduralcontext (e.g., knowing the type of tissue being operated on or the typeof procedure being performed), the control algorithm may control themodular device incorrectly or suboptimally given the particularcontext-free sensed data. For example, the optimal manner for a controlalgorithm to control a surgical instrument in response to a particularsensed parameter can vary according to the particular tissue type beingoperated on. This is due to the fact that different tissue types havedifferent properties (e.g., resistance to tearing) and thus responddifferently to actions taken by surgical instruments. Therefore, it maybe desirable for a surgical instrument to take different actions evenwhen the same measurement for a particular parameter is sensed. As onespecific example, the optimal manner in which to control a surgicalstapling and cutting instrument in response to the instrument sensing anunexpectedly high force to close its end effector will vary dependingupon whether the tissue type is susceptible or resistant to tearing. Fortissues that are susceptible to tearing, such as lung tissue, theinstrument's control algorithm would optimally ramp down the motor inresponse to an unexpectedly high force to close to avoid tearing thetissue. For tissues that are resistant to tearing, such as stomachtissue, the instrument's control algorithm would optimally ramp up themotor in response to an unexpectedly high force to close to ensure thatthe end effector is clamped properly on the tissue. Without knowingwhether lung or stomach tissue has been clamped, the control algorithmmay make a suboptimal decision.

One solution utilizes a surgical hub including a system that isconfigured to derive information about the surgical procedure beingperformed based on data received from various data sources and thencontrol the paired modular devices accordingly. In other words, thesurgical hub is configured to infer information about the surgicalprocedure from received data and then control the modular devices pairedto the surgical hub based upon the inferred context of the surgicalprocedure. FIG. 23 illustrates a diagram of a situationally awaresurgical system 5100, in accordance with at least one aspect of thepresent disclosure. In some exemplifications, the data sources 5126include, for example, the modular devices 5102 (which can includesensors configured to detect parameters associated with the patientand/or the modular device itself), databases 5122 (e.g., an EMR databasecontaining patient records), and patient monitoring devices 5124 (e.g.,a blood pressure (BP) monitor and an electrocardiography (EKG) monitor).The surgical hub 5104 can be configured to derive the contextualinformation pertaining to the surgical procedure from the data basedupon, for example, the particular combination(s) of received data or theparticular order in which the data is received from the data sources5126. The contextual information inferred from the received data caninclude, for example, the type of surgical procedure being performed,the particular step of the surgical procedure that the surgeon isperforming, the type of tissue being operated on, or the body cavitythat is the subject of the procedure. This ability by some aspects ofthe surgical hub 5104 to derive or infer information related to thesurgical procedure from received data can be referred to as “situationalawareness.” In one exemplification, the surgical hub 5104 canincorporate a situational awareness system, which is the hardware and/orprogramming associated with the surgical hub 5104 that derivescontextual information pertaining to the surgical procedure from thereceived data.

The situational awareness system of the surgical hub 5104 can beconfigured to derive the contextual information from the data receivedfrom the data sources 5126 in a variety of different ways. In oneexemplification, the situational awareness system includes a patternrecognition system, or machine learning system (e.g., an artificialneural network), that has been trained on training data to correlatevarious inputs (e.g., data from databases 5122, patient monitoringdevices 5124, and/or modular devices 5102) to corresponding contextualinformation regarding a surgical procedure. In other words, a machinelearning system can be trained to accurately derive contextualinformation regarding a surgical procedure from the provided inputs. Inanother exemplification, the situational awareness system can include alookup table storing pre-characterized contextual information regardinga surgical procedure in association with one or more inputs (or rangesof inputs) corresponding to the contextual information. In response to aquery with one or more inputs, the lookup table can return thecorresponding contextual information for the situational awarenesssystem for controlling the modular devices 5102. In one exemplification,the contextual information received by the situational awareness systemof the surgical hub 5104 is associated with a particular controladjustment or set of control adjustments for one or more modular devices5102. In another exemplification, the situational awareness systemincludes a further machine learning system, lookup table, or other suchsystem, which generates or retrieves one or more control adjustments forone or more modular devices 5102 when provided the contextualinformation as input.

A surgical hub 5104 incorporating a situational awareness systemprovides a number of benefits for the surgical system 5100. One benefitincludes improving the interpretation of sensed and collected data,which would in turn improve the processing accuracy and/or the usage ofthe data during the course of a surgical procedure. To return to aprevious example, a situationally aware surgical hub 5104 coulddetermine what type of tissue was being operated on; therefore, when anunexpectedly high force to close the surgical instrument's end effectoris detected, the situationally aware surgical hub 5104 could correctlyramp up or ramp down the motor of the surgical instrument for the typeof tissue.

As another example, the type of tissue being operated can affect theadjustments that are made to the compression rate and load thresholds ofa surgical stapling and cutting instrument for a particular tissue gapmeasurement. A situationally aware surgical hub 5104 could infer whethera surgical procedure being performed is a thoracic or an abdominalprocedure, allowing the surgical hub 5104 to determine whether thetissue clamped by an end effector of the surgical stapling and cuttinginstrument is lung (for a thoracic procedure) or stomach (for anabdominal procedure) tissue. The surgical hub 5104 could then adjust thecompression rate and load thresholds of the surgical stapling andcutting instrument appropriately for the type of tissue.

As yet another example, the type of body cavity being operated in duringan insufflation procedure can affect the function of a smoke evacuator.A situationally aware surgical hub 5104 could determine whether thesurgical site is under pressure (by determining that the surgicalprocedure is utilizing insufflation) and determine the procedure type.As a procedure type is generally performed in a specific body cavity,the surgical hub 5104 could then control the motor rate of the smokeevacuator appropriately for the body cavity being operated in. Thus, asituationally aware surgical hub 5104 could provide a consistent amountof smoke evacuation for both thoracic and abdominal procedures.

As yet another example, the type of procedure being performed can affectthe optimal energy level for an ultrasonic surgical instrument or radiofrequency (RF) electrosurgical instrument to operate at. Arthroscopicprocedures, for example, require higher energy levels because the endeffector of the ultrasonic surgical instrument or RF electrosurgicalinstrument is immersed in fluid. A situationally aware surgical hub 5104could determine whether the surgical procedure is an arthroscopicprocedure. The surgical hub 5104 could then adjust the RF power level orthe ultrasonic amplitude of the generator (i.e., “energy level”) tocompensate for the fluid filled environment. Relatedly, the type oftissue being operated on can affect the optimal energy level for anultrasonic surgical instrument or RF electrosurgical instrument tooperate at. A situationally aware surgical hub 5104 could determine whattype of surgical procedure is being performed and then customize theenergy level for the ultrasonic surgical instrument or RFelectrosurgical instrument, respectively, according to the expectedtissue profile for the surgical procedure. Furthermore, a situationallyaware surgical hub 5104 can be configured to adjust the energy level forthe ultrasonic surgical instrument or RF electrosurgical instrumentthroughout the course of a surgical procedure, rather than just on aprocedure-by-procedure basis. A situationally aware surgical hub 5104could determine what step of the surgical procedure is being performedor will subsequently be performed and then update the control algorithmsfor the generator and/or ultrasonic surgical instrument or RFelectrosurgical instrument to set the energy level at a valueappropriate for the expected tissue type according to the surgicalprocedure step.

As yet another example, data can be drawn from additional data sources5126 to improve the conclusions that the surgical hub 5104 draws fromone data source 5126. A situationally aware surgical hub 5104 couldaugment data that it receives from the modular devices 5102 withcontextual information that it has built up regarding the surgicalprocedure from other data sources 5126. For example, a situationallyaware surgical hub 5104 can be configured to determine whetherhemostasis has occurred (i.e., whether bleeding at a surgical site hasstopped) according to video or image data received from a medicalimaging device. However, in some cases the video or image data can beinconclusive. Therefore, in one exemplification, the surgical hub 5104can be further configured to compare a physiologic measurement (e.g.,blood pressure sensed by a BP monitor communicably connected to thesurgical hub 5104) with the visual or image data of hemostasis (e.g.,from a medical imaging device 124 (FIG. 2 ) communicably coupled to thesurgical hub 5104) to make a determination on the integrity of thestaple line or tissue weld. In other words, the situational awarenesssystem of the surgical hub 5104 can consider the physiologicalmeasurement data to provide additional context in analyzing thevisualization data. The additional context can be useful when thevisualization data may be inconclusive or incomplete on its own.

Another benefit includes proactively and automatically controlling thepaired modular devices 5102 according to the particular step of thesurgical procedure that is being performed to reduce the number of timesthat medical personnel are required to interact with or control thesurgical system 5100 during the course of a surgical procedure. Forexample, a situationally aware surgical hub 5104 could proactivelyactivate the generator to which an RF electrosurgical instrument isconnected if it determines that a subsequent step of the procedurerequires the use of the instrument. Proactively activating the energysource allows the instrument to be ready for use a soon as the precedingstep of the procedure is completed.

As another example, a situationally aware surgical hub 5104 coulddetermine whether the current or subsequent step of the surgicalprocedure requires a different view or degree of magnification on thedisplay according to the feature(s) at the surgical site that thesurgeon is expected to need to view. The surgical hub 5104 could thenproactively change the displayed view (supplied by, e.g., a medicalimaging device for the visualization system 108) accordingly so that thedisplay automatically adjusts throughout the surgical procedure.

As yet another example, a situationally aware surgical hub 5104 coulddetermine which step of the surgical procedure is being performed orwill subsequently be performed and whether particular data orcomparisons between data will be required for that step of the surgicalprocedure. The surgical hub 5104 can be configured to automatically callup data screens based upon the step of the surgical procedure beingperformed, without waiting for the surgeon to ask for the particularinformation.

Another benefit includes checking for errors during the setup of thesurgical procedure or during the course of the surgical procedure. Forexample, a situationally aware surgical hub 5104 could determine whetherthe operating theater is setup properly or optimally for the surgicalprocedure to be performed. The surgical hub 5104 can be configured todetermine the type of surgical procedure being performed, retrieve thecorresponding checklists, product location, or setup needs (e.g., from amemory), and then compare the current operating theater layout to thestandard layout for the type of surgical procedure that the surgical hub5104 determines is being performed. In one exemplification, the surgicalhub 5104 can be configured to compare the list of items for theprocedure (scanned by a scanner, for example) and/or a list of devicespaired with the surgical hub 5104 to a recommended or anticipatedmanifest of items and/or devices for the given surgical procedure. Ifthere are any discontinuities between the lists, the surgical hub 5104can be configured to provide an alert indicating that a particularmodular device 5102, patient monitoring device 5124, and/or othersurgical item is missing. In one exemplification, the surgical hub 5104can be configured to determine the relative distance or position of themodular devices 5102 and patient monitoring devices 5124 via proximitysensors, for example. The surgical hub 5104 can compare the relativepositions of the devices to a recommended or anticipated layout for theparticular surgical procedure. If there are any discontinuities betweenthe layouts, the surgical hub 5104 can be configured to provide an alertindicating that the current layout for the surgical procedure deviatesfrom the recommended layout.

As another example, a situationally aware surgical hub 5104 coulddetermine whether the surgeon (or other medical personnel) was making anerror or otherwise deviating from the expected course of action duringthe course of a surgical procedure. For example, the surgical hub 5104can be configured to determine the type of surgical procedure beingperformed, retrieve the corresponding list of steps or order ofequipment usage (e.g., from a memory), and then compare the steps beingperformed or the equipment being used during the course of the surgicalprocedure to the expected steps or equipment for the type of surgicalprocedure that the surgical hub 5104 determined is being performed. Inone exemplification, the surgical hub 5104 can be configured to providean alert indicating that an unexpected action is being performed or anunexpected device is being utilized at the particular step in thesurgical procedure.

Overall, the situational awareness system for the surgical hub 5104improves surgical procedure outcomes by adjusting the surgicalinstruments (and other modular devices 5102) for the particular contextof each surgical procedure (such as adjusting to different tissue types)and validating actions during a surgical procedure. The situationalawareness system also improves surgeons' efficiency in performingsurgical procedures by automatically suggesting next steps, providingdata, and adjusting displays and other modular devices 5102 in thesurgical theater according to the specific context of the procedure.

Modular Energy System

ORs everywhere in the world are a tangled web of cords, devices, andpeople due to the amount of equipment required to perform surgicalprocedures. Surgical capital equipment tends to be a major contributorto this issue because most surgical capital equipment performs a single,specialized task. Due to their specialized nature and the surgeons'needs to utilize multiple different types of devices during the courseof a single surgical procedure, an OR may be forced to be stocked withtwo or even more pieces of surgical capital equipment, such as energygenerators. Each of these pieces of surgical capital equipment must beindividually plugged into a power source and may be connected to one ormore other devices that are being passed between OR personnel, creatinga tangle of cords that must be navigated. Another issue faced in modernORs is that each of these specialized pieces of surgical capitalequipment has its own user interface and must be independentlycontrolled from the other pieces of equipment within the OR. Thiscreates complexity in properly controlling multiple different devices inconnection with each other and forces users to be trained on andmemorize different types of user interfaces (which may further changebased upon the task or surgical procedure being performed, in additionto changing between each piece of capital equipment). This cumbersome,complex process can necessitate the need for even more individuals to bepresent within the OR and can create danger if multiple devices are notproperly controlled in tandem with each other. Therefore, consolidatingsurgical capital equipment technology into singular systems that areable to flexibly address surgeons' needs to reduce the footprint ofsurgical capital equipment within ORs would simplify the userexperience, reduce the amount of clutter in ORs, and preventdifficulties and dangers associated with simultaneously controllingmultiple pieces of capital equipment. Further, making such systemsexpandable or customizable would allow for new technology to beconveniently incorporated into existing surgical systems, obviating theneed to replace entire surgical systems or for OR personnel to learn newuser interfaces or equipment controls with each new technology.

As described in FIGS. 1-11 , a surgical hub 106 can be configured tointerchangeably receive a variety of modules, which can in turninterface with surgical devices (e.g., a surgical instrument or a smokeevacuator) or provide various other functions (e.g., communications). Inone aspect, a surgical hub 106 can be embodied as a modular energysystem 2000, which is illustrated in connection with FIGS. 24-30 . Themodular energy system 2000 can include a variety of different modules2001 that are connectable together in a stacked configuration. In oneaspect, the modules 2001 can be both physically and communicably coupledtogether when stacked or otherwise connected together into a singularassembly. Further, the modules 2001 can be interchangeably connectabletogether in different combinations or arrangements. In one aspect, eachof the modules 2001 can include a consistent or universal array ofconnectors disposed along their upper and lower surfaces, therebyallowing any module 2001 to be connected to another module 2001 in anyarrangement (except that, in some aspects, a particular module type,such as the header module 2002, can be configured to serve as theuppermost module within the stack, for example). In an alternativeaspect, the modular energy system 2000 can include a housing that isconfigured to receive and retain the modules 2001, as is shown in FIGS.3 and 4 . The modular energy system 2000 can also include a variety ofdifferent components or accessories that are also connectable to orotherwise associatable with the modules 2001. In another aspect, themodular energy system 2000 can be embodied as a generator module 140,240 (FIGS. 3 and 10 ) of a surgical hub 106. In yet another aspect, themodular energy system 2000 can be a distinct system from a surgical hub106. In such aspects, the modular energy system 2000 can be communicablycouplable to a surgical hub 206 for transmitting and/or receiving datatherebetween.

The modular energy system 2000 can be assembled from a variety ofdifferent modules 2001, some examples of which are illustrated in FIG.24 . Each of the different types of modules 2001 can provide differentfunctionality, thereby allowing the modular energy system 2000 to beassembled into different configurations to customize the functions andcapabilities of the modular energy system 2000 by customizing themodules 2001 that are included in each modular energy system 2000. Themodules 2001 of the modular energy system 2000 can include, for example,a header module 2002 (which can include a display screen 2006), anenergy module 2004, a technology module 2040, and a visualization module2042. In the depicted aspect, the header module 2002 is configured toserve as the top or uppermost module within the modular energy systemstack and can thus lack connectors along its top surface. In anotheraspect, the header module 2002 can be configured to be positioned at thebottom or the lowermost module within the modular energy system stackand can thus lack connectors along its bottom surface. In yet anotheraspect, the header module 2002 can be configured to be positioned at anintermediate position within the modular energy system stack and canthus include connectors along both its bottom and top surfaces. Theheader module 2002 can be configured to control the system-wide settingsof each module 2001 and component connected thereto through physicalcontrols 2011 thereon and/or a graphical user interface (GUI) 2008rendered on the display screen 2006. Such settings could include theactivation of the modular energy system 2000, the volume of alerts, thefootswitch settings, the settings icons, the appearance or configurationof the user interface, the surgeon profile logged into the modularenergy system 2000, and/or the type of surgical procedure beingperformed. The header module 2002 can also be configured to providecommunications, processing, and/or power for the modules 2001 that areconnected to the header module 2002. The energy module 2004, which canalso be referred to as a generator module 140, 240 (FIGS. 3 and 10 ),can be configured to generate one or multiple energy modalities fordriving electrosurgical and/or ultrasonic surgical instruments connectedthereto, such as is described above in connection with the generator 900illustrated in FIG. 21 . The technology module 2040 can be configured toprovide additional or expanded control algorithms (e.g., electrosurgicalor ultrasonic control algorithms for controlling the energy output ofthe energy module 2004). The visualization module 2042 can be configuredto interface with visualization devices (i.e., scopes) and accordinglyprovide increased visualization capabilities.

The modular energy system 2000 can further include a variety ofaccessories 2029 that are connectable to the modules 2001 forcontrolling the functions thereof or that are otherwise configured towork on conjunction with the modular energy system 2000. The accessories2029 can include, for example, a single-pedal footswitch 2032, adual-pedal footswitch 2034, and a cart 2030 for supporting the modularenergy system 2000 thereon. The footswitches 2032, 2034 can beconfigured to control the activation or function of particular energymodalities output by the energy module 2004, for example.

By utilizing modular components, the depicted modular energy system 2000provides a surgical platform that grows with the availability oftechnology and is customizable to the needs of the facility and/orsurgeons. Further, the modular energy system 2000 supports combo devices(e.g., dual electrosurgical and ultrasonic energy generators) andsupports software-driven algorithms for customized tissue effects. Stillfurther, the surgical system architecture reduces the capital footprintby combining multiple technologies critical for surgery into a singlesystem.

The various modular components utilizable in connection with the modularenergy system 2000 can include monopolar energy generators, bipolarenergy generators, dual electrosurgical/ultrasonic energy generators,display screens, and various other modules and/or other components, someof which are also described above in connection with FIGS. 1-11 .

Referring now to FIG. 25A, the header module 2002 can, in some aspects,include a display screen 2006 that renders a GUI 2008 for relayinginformation regarding the modules 2001 connected to the header module2002. In some aspects, the GUI 2008 of the display screen 2006 canprovide a consolidated point of control of all of the modules 2001making up the particular configuration of the modular energy system2000. Various aspects of the GUI 2008 are discussed in fuller detailbelow in connection with FIG. 30 . In alternative aspects, the headermodule 2002 can lack the display screen 2006 or the display screen 2006can be detachably connected to the housing 2010 of the header module2002. In such aspects, the header module 2002 can be communicablycouplable to an external system that is configured to display theinformation generated by the modules 2001 of the modular energy system2000. For example, in robotic surgical applications, the modular energysystem 2000 can be communicably couplable to a robotic cart or roboticcontrol console, which is configured to display the informationgenerated by the modular energy system 2000 to the operator of therobotic surgical system. As another example, the modular energy system2000 can be communicably couplable to a mobile display that can becarried or secured to a surgical staff member for viewing thereby. Inyet another example, the modular energy system 2000 can be communicablycouplable to a surgical hub 2100 or another computer system that caninclude a display 2104, as is illustrated in FIG. 29 . In aspectsutilizing a user interface that is separate from or otherwise distinctfrom the modular energy system 2000, the user interface can bewirelessly connectable with the modular energy system 2000 as a whole orone or more modules 2001 thereof such that the user interface candisplay information from the connected modules 2001 thereon.

Referring still to FIG. 25A, the energy module 2004 can include a portassembly 2012 including a number of different ports configured todeliver different energy modalities to corresponding surgicalinstruments that are connectable thereto. In the particular aspectillustrated in FIGS. 24-30 , the port assembly 2012 includes a bipolarport 2014, a first monopolar port 2016 a, a second monopolar port 2018b, a neutral electrode port 2018 (to which a monopolar return pad isconnectable), and a combination energy port 2020. However, thisparticular combination of ports is simply provided for illustrativepurposes and alternative combinations of ports and/or energy modalitiesmay be possible for the port assembly 2012.

As noted above, the modular energy system 2000 can be assembled intodifferent configurations. Further, the different configurations of themodular energy system 2000 can also be utilizable for different surgicalprocedure types and/or different tasks. For example, FIGS. 25A and 25Billustrate a first illustrative configuration of the modular energysystem 2000 including a header module 2002 (including a display screen2006) and an energy module 2004 connected together. Such a configurationcan be suitable for laparoscopic and open surgical procedures, forexample.

FIG. 26A illustrates a second illustrative configuration of the modularenergy system 2000 including a header module 2002 (including a displayscreen 2006), a first energy module 2004 a, and a second energy module2004 b connected together. By stacking two energy modules 2004 a, 2004b, the modular energy system 2000 can provide a pair of port assemblies2012 a, 2012 b for expanding the array of energy modalities deliverableby the modular energy system 2000 from the first configuration. Thesecond configuration of the modular energy system 2000 can accordinglyaccommodate more than one bipolar/monopolar electrosurgical instrument,more than two bipolar/monopolar electrosurgical instruments, and so on.Such a configuration can be suitable for particularly complexlaparoscopic and open surgical procedures. FIG. 26B illustrates a thirdillustrative configuration that is similar to the second configuration,except that the header module 2002 lacks a display screen 2006. Thisconfiguration can be suitable for robotic surgical applications ormobile display applications, as noted above.

FIG. 27 illustrates a fourth illustrative configuration of the modularenergy system 2000 including a header module 2002 (including a displayscreen 2006), a first energy module 2004 a, a second energy module 2004b, and a technology module 2040 connected together. Such a configurationcan be suitable for surgical applications where particularly complex orcomputation-intensive control algorithms are required. Alternatively,the technology module 2040 can be a newly released module thatsupplements or expands the capabilities of previously released modules(such as the energy module 2004).

FIG. 28 illustrates a fifth illustrative configuration of the modularenergy system 2000 including a header module 2002 (including a displayscreen 2006), a first energy module 2004 a, a second energy module 2004b, a technology module 2040, and a visualization module 2042 connectedtogether. Such a configuration can be suitable for endoscopic proceduresby providing a dedicated surgical display 2044 for relaying the videofeed from the scope coupled to the visualization module 2042. It shouldbe noted that the configurations illustrated in FIGS. 25A-29 anddescribed above are provided simply to illustrate the various conceptsof the modular energy system 2000 and should not be interpreted to limitthe modular energy system 2000 to the particular aforementionedconfigurations.

As noted above, the modular energy system 2000 can be communicablycouplable to an external system, such as a surgical hub 2100 asillustrated in FIG. 29 . Such external systems can include a displayscreen 2104 for displaying a visual feed from an endoscope (or a cameraor another such visualization device) and/or data from the modularenergy system 2000. Such external systems can also include a computersystem 2102 for performing calculations or otherwise analyzing datagenerated or provided by the modular energy system 2000, controlling thefunctions or modes of the modular energy system 2000, and/or relayingdata to a cloud computing system or another computer system. Suchexternal systems could also coordinate actions between multiple modularenergy systems 2000 and/or other surgical systems (e.g., a visualizationsystem 108 and/or a robotic system 110 as described in connection withFIGS. 1 and 2 ).

Referring now to FIG. 30 , in some aspects, the header module 2002 caninclude or support a display 2006 configured for displaying a GUI 2008,as noted above. The display screen 2006 can include a touchscreen forreceiving input from users in addition to displaying information. Thecontrols displayed on the GUI 2008 can correspond to the module(s) 2001that are connected to the header module 2002. In some aspects, differentportions or areas of the GUI 2008 can correspond to particular modules2001. For example, a first portion or area of the GUI 2008 cancorrespond to a first module and a second portion or area of the GUI2008 can correspond to a second module. As different and/or additionalmodules 2001 are connected to the modular energy system stack, the GUI2008 can adjust to accommodate the different and/or additional controlsfor each newly added module 2001 or remove controls for each module 2001that is removed. Each portion of the display corresponding to aparticular module connected to the header module 2002 can displaycontrols, data, user prompts, and/or other information corresponding tothat module. For example, in FIG. 30 , a first or upper portion 2052 ofthe depicted GUI 2008 displays controls and data associated with anenergy module 2004 that is connected to the header module 2002. Inparticular, the first portion 2052 of the GUI 2008 for the energy module2004 provides first widget 2056 a corresponding to the bipolar port2014, a second widget 2056 b corresponding to the first monopolar port2016 a, a third widget 2056 c corresponding to the second monopolar port2016 b, and a fourth widget 2056 d corresponding to the combinationenergy port 2020. Each of these widgets 2056 a-d provides data relatedto its corresponding port of the port assembly 2012 and controls forcontrolling the modes and other features of the energy modalitydelivered by the energy module 2004 through the respective port of theport assembly 2012. For example, the widgets 2056 a-d can be configuredto display the power level of the surgical instrument connected to therespective port, change the operational mode of the surgical instrumentconnected to the respective port (e.g., change a surgical instrumentfrom a first power level to a second power level and/or change amonopolar surgical instrument from a “spray” mode to a “blend” mode),and so on.

In one aspect, the header module 2002 can include various physicalcontrols 2011 in addition to or in lieu of the GUI 2008. Such physicalcontrols 2011 can include, for example, a power button that controls theactivation of each module 2001 that is connected to the header module2002 in the modular energy system 2000. Alternatively, the power buttoncan be displayed as part of the GUI 2008. Therefore, the header module2002 can serve as a single point of contact and obviate the need toindividually activate and deactivate each individual module 2001 fromwhich the modular energy system 2000 is constructed.

In one aspect, the header module 2002 can display still images, videos,animations, and/or information associated with the surgical modules 2001of which the modular energy system 2000 is constructed or the surgicaldevices that are communicably coupled to the modular energy system 2000.The still images and/or videos displayed by the header module 2002 canbe received from an endoscope or another visualization device that iscommunicably coupled to the modular energy system 2000. The animationsand/or information of the GUI 2008 can be overlaid on or displayedadjacent to the images or video feed.

In one aspect, the modules 2001 other than the header module 2002 can beconfigured to likewise relay information to users. For example, theenergy module 2004 can include light assemblies 2015 disposed about eachof the ports of the port assembly 2012. The light assemblies 2015 can beconfigured to relay information to the user regarding the port accordingto their color or state (e.g., flashing). For example, the lightassemblies 2015 can change from a first color to a second color when aplug is fully seated within the respective port. In one aspect, thecolor or state of the light assemblies 2015 can be controlled by theheader module 2002. For example, the header module 2002 can cause thelight assembly 2015 of each port to display a color corresponding to thecolor display for the port on the GUI 2008.

FIG. 31 is a block diagram of a stand-alone hub configuration of amodular energy system 3000, in accordance with at least one aspect ofthe present disclosure and FIG. 32 is a block diagram of a hubconfiguration of a modular energy system 3000 integrated with a surgicalcontrol system 3010, in accordance with at least one aspect of thepresent disclosure. As depicted in FIGS. 31 and 32 , the modular energysystem 3000 can be either utilized as stand-alone units or integratedwith a surgical control system 3010 that controls and/or receives datafrom one or more surgical hub units. In the examples illustrated inFIGS. 31 and 32 , the integrated header/UI module 3002 of the modularenergy system 3000 includes a header module and a UI module integratedtogether as a singular module. In other aspects, the header module andthe UI module can be provided as separate components that arecommunicatively coupled though a data bus 3008.

As illustrated in FIG. 31 , an example of a stand-alone modular energysystem 3000 includes an integrated header module/user interface (UI)module 3002 coupled to an energy module 3004. Power and data aretransmitted between the integrated header/UI module 3002 and the energymodule 3004 through a power interface 3006 and a data interface 3008.For example, the integrated header/UI module 3002 can transmit variouscommands to the energy module 3004 through the data interface 3008. Suchcommands can be based on user inputs from the UI. As a further example,power may be transmitted to the energy module 3004 through the powerinterface 3006.

In FIG. 32 , a surgical hub configuration includes a modular energysystem 3000 integrated with a control system 3010 and an interfacesystem 3022 for managing, among other things, data and powertransmission to and/or from the modular energy system 3000. The modularenergy system depicted in FIG. 32 includes an integrated headermodule/UI module 3002, a first energy module 3004, and a second energymodule 3012. In one example, a data transmission pathway is establishedbetween the system control unit 3024 of the control system 3010 and thesecond energy module 3012 through the first energy module 3004 and theheader/UI module 3002 through a data interface 3008. In addition, apower pathway extends between the integrated header/UI module 3002 andthe second energy module 3012 through the first energy module 3004through a power interface 3006. In other words, in one aspect, the firstenergy module 3004 is configured to function as a power and datainterface between the second energy module 3012 and the integratedheader/UI module 3002 through the power interface 3006 and the datainterface 3008. This arrangement allows the modular energy system 3000to expand by seamlessly connecting additional energy modules to energymodules 3004, 3012 that are already connected to the integratedheader/UI module 3002 without the need for dedicated power and energyinterfaces within the integrated header/UI module 3002.

The system control unit 3024, which may be referred to herein as acontrol circuit, control logic, microprocessor, microcontroller, logic,or FPGA, or various combinations thereof, is coupled to the systeminterface 3022 via energy interface 3026 and instrument communicationinterface 3028. The system interface 3022 is coupled to the first energymodule 3004 via a first energy interface 3014 and a first instrumentcommunication interface 3016. The system interface 3022 is coupled tothe second energy module 3012 via a second energy interface 3018 and asecond instrument communication interface 3020. As additional modules,such as additional energy modules, are stacked in the modular energysystem 3000, additional energy and communications interfaces areprovided between the system interface 3022 and the additional modules.

As described in more detail hereinbelow, the energy modules 3004, 3012are connectable to a hub and can be configured to generateelectrosurgical energy (e.g., bipolar or monopolar), ultrasonic energy,or a combination thereof (referred to herein as an “advanced energy”module) for a variety of energy surgical instruments. Generally, theenergy modules 3004, 3012 include hardware/software interfaces, anultrasonic controller, an advanced energy RF controller, bipolar RFcontroller, and control algorithms executed by the controller thatreceives outputs from the controller and controls the operation of thevarious energy modules 3004, 3012 accordingly. In various aspects of thepresent disclosure, the controllers described herein may be implementedas a control circuit, control logic, microprocessor, microcontroller,logic, or FPGA, or various combinations thereof.

FIGS. 33-35 are block diagrams of various modular energy systemsconnected together to form a hub, in accordance with at least one aspectof the present disclosure. FIGS. 33-35 depict various diagrams (e.g.,circuit or control diagrams) of hub modules. The modular energy system3000 includes multiple energy modules 3004 (FIG. 34 ), 3012 (FIG. 35 ),a header module 3150 (FIG. 35 ), a UI module 3030 (FIG. 33 ), and acommunications module 3032 (FIG. 33 ), in accordance with at least oneaspect of the present disclosure. The UI module 3030 includes a touchscreen 3046 displaying various relevant information and various usercontrols for controlling one or more parameters of the modular energysystem 3000. The UI module 3030 is attached to the top header module3150, but is separately housed so that it can be manipulatedindependently of the header module 3150. For example, the UI module 3030can be picked up by a user and/or reattached to the header module 3150.Additionally, or alternatively, the UI module 3030 can be slightly movedrelative to the header module 3150 to adjust its position and/ororientation. For example, the UI module 3030 can be tilted and/orrotated relative to the header module 3150.

In some aspects, the various hub modules can include light piping aroundthe physical ports to communicate instrument status and also connecton-screen elements to corresponding instruments. Light piping is oneexample of an illumination technique that may be employed to alert auser to a status of a surgical instrument attached/connected to aphysical port. In one aspect, illuminating a physical port with aparticular light directs a user to connect a surgical instrument to thephysical port. In another example, illuminating a physical port with aparticular light alerts a user to an error related an existingconnection with a surgical instrument.

Turning to FIG. 33 , there is shown a block diagram of a user interface(UI) module 3030 coupled to a communications module 3032 via apass-through hub connector 3034, in accordance with at least one aspectof the present disclosure. The UI module 3030 is provided as a separatecomponent from a header module 3150 (shown in FIG. 35 ) and may becommunicatively coupled to the header module 3150 via a communicationsmodule 3032, for example. In one aspect, the UI module 3030 can includea UI processor 3040 that is configured to represent declarativevisualizations and behaviors received from other connected modules, aswell as perform other centralized UI functionality, such as systemconfiguration (e.g., language selection, module associations, etc.). TheUI processor 3040 can be, for example, a processor or system on module(SOM) running a framework such as Qt, .NET WPF, Web server, or similar.

In the illustrated example, the UI module 3030 includes a touchscreen3046, a liquid crystal display 3048 (LCD), and audio output 3052 (e.g.,speaker, buzzer). The UI processor 3040 is configured to receivetouchscreen inputs from a touch controller 3044 coupled between thetouch screen 3046 and the UI processor 3040. The UI processor 3040 isconfigured to output visual information to the LCD display 3048 and tooutput audio information the audio output 3052 via an audio amplifier3050. The UI processor 3040 is configured to interface to thecommunications module 3032 via a switch 3042 coupled to the pass-throughhub connector 3034 to receive, process, and forward data from the sourcedevice to the destination device and control data communicationtherebetween. DC power is supplied to the UI module 3030 via DC/DCconverter modules 3054. The DC power is passed through the pass-throughhub connector 3034 to the communications module 3032 through the powerbus 3006. Data is passed through the pass-through hub connector 3034 tothe communications module 3032 through the data bus 3008. Switches 3042,3056 receive, process, and forward data from the source device to thedestination device.

Continuing with FIG. 33 , the communications module 3032, as well asvarious surgical hubs and/or surgical systems can include a gateway 3058that is configured to shuttle select traffic (i.e., data) between twodisparate networks (e.g., an internal network and/or a hospital network)that are running different protocols. The communications module 3032includes a first pass-through hub connector 3036 to couple thecommunications module 3032 to other modules. In the illustrated example,the communications module 3032 is coupled to the UI module 3030. Thecommunications module 3032 is configured to couple to other modules(e.g., energy modules) via a second pass-through hub connector 3038 tocouple the communications module 3032 to other modules via a switch 3056disposed between the first and second pass-through hub connectors 3036,3038 to receive, process, and forward data from the source device to thedestination device and control data communication therebetween. Theswitch 3056 also is coupled to a gateway 3058 to communicate informationbetween external communications ports and the UI module 3030 and otherconnected modules. The gateway 3058 may be coupled to variouscommunications modules such as, for example, an Ethernet module 3060 tocommunicate to a hospital or other local network, a universal serial bus(USB) module 3062, a WiFi module 3064, and a Bluetooth module 3066,among others. The communications modules may be physical boards locatedwithin the communications module 3032 or may be a port to couple toremote communications boards.

In some aspects, all of the modules (i.e., detachable hardware) arecontrolled by a single UI module 3030 that is disposed on or integral toa header module. FIG. 35 shows a stand alone header module 3150 to whichthe UI module 3030 can be attached. FIGS. 31, 32 , and 36 show anintegrated header/UI Module 3002. Returning now to FIG. 33 , in variousaspects, by consolidating all of the modules into a single, responsiveUI module 3002, the system provides a simpler way to control and monitormultiple pieces of equipment at once. This approach drastically reducesfootprint and complexity in an operating room (OR).

Turning to FIG. 34 , there is shown a block diagram of an energy module3004, in accordance with at least one aspect of the present disclosure.The communications module 3032 (FIG. 33 ) is coupled to the energymodule 3004 via the second pass-through hub connector 3038 of thecommunications module 3032 and a first pass-through hub connector 3074of the energy module 3004. The energy module 3004 may be coupled toother modules, such as a second energy module 3012 shown in FIG. 35 ,via a second pass-through hub connector 3078. Turning back to FIG. 34 ,a switch 3076 disposed between the first and second pass-through hubconnectors 3074, 3078 receives, processes, and forwards data from thesource device to the destination device and controls data communicationtherebetween. Data is received and transmitted through the data bus3008. The energy module 3032 includes a controller 3082 to controlvarious communications and processing functions of the energy module3004.

DC power is received and transmitted by the energy module 3004 throughthe power bus 3006. The power bus 3006 is coupled to DC/DC convertermodules 3138 to supply power to adjustable regulators 3084, 3107 andisolated DC/DC converter ports 3096, 3112, 3132.

In one aspect, the energy module 3004 can include an ultrasonic widebandamplifier 3086, which in one aspect may be a linear class H amplifierthat is capable of generating arbitrary waveforms and drive harmonictransducers at low total harmonic distortion (THD) levels. Theultrasonic wideband amplifier 3086 is fed by a buck adjustable regulator3084 to maximize efficiency and controlled by the controller 3082, whichmay be implemented as a digital signal processor (DSP) via a directdigital synthesizer (DDS), for example. The DDS can either be embeddedin the DSP or implemented in the field-programmable gate array (FPGA),for example. The controller 3082 controls the ultrasonic widebandamplifier 3086 via a digital-to-analog converter 3106 (DAC). The outputof the ultrasonic wideband amplifier 3086 is fed to an ultrasonic powertransformer 3088, which is coupled to an ultrasonic energy outputportion of an advanced energy receptacle 3100. Ultrasonic voltage (V)and current (I) feedback (FB) signals, which may be employed to computeultrasonic impedance, are fed back to the controller 3082 via anultrasonic VI FB transformer 3092 through an input portion of theadvanced energy receptacle 3100. The ultrasonic voltage and currentfeedback signals are routed back to the controller 3082 through ananalog-to-digital converter 3102 (A/D). Also coupled to the controller3082 through the advanced energy receptacle 3100 is the isolated DC/DCconverter port 3096, which receives DC power from the power bus 3006,and a medium bandwidth data port 3098.

In one aspect, the energy module 3004 can include a wideband RF poweramplifier 3108, which in one aspect may be a linear class H amplifierthat is capable of generating arbitrary waveforms and drive RF loads ata range of output frequencies. The wideband RF power amplifier 3108 isfed by an adjustable buck regulator 3107 to maximize efficiency andcontrolled by the controller 3082, which may be implemented as DSP via aDDS. The DDS can either be embedded in the DSP or implemented in theFPGA, for example. The controller 3082 controls the wideband RFamplifier 3086 via a DAC 3122. The output of the wideband RF poweramplifier 3108 can be fed through RF selection relays 3124. The RFselection relays 3124 are configured to receive and selectively transmitthe output signal of the wideband RF power amplifier 3108 to variousother components of the energy module 3004. In one aspect, the outputsignal of the wideband RF power amplifier 3108 can be fed through RFselection relays 3124 to an RF power transformer 3110, which is coupledto an RF output portion of a bipolar RF energy receptacle 3118. BipolarRF voltage (V) and current (I) feedback (FB) signals, which may beemployed to compute RF impedance, are fed back to the controller 3082via an RF VI FB transformer 3114 through an input portion of the bipolarRF energy receptacle 3118. The RF voltage and current feedback signalsare routed back to the controller 3082 through an A/D 3120. Also coupledto the controller 3082 through the bipolar RF energy receptacle 3118 isthe isolated DC/DC converter port 3112, which receives DC power from thepower bus 3006, and a low bandwidth data port 3116.

As described above, in one aspect, the energy module 3004 can include RFselection relays 3124 driven by the controller 3082 (e.g., FPGA) atrated coil current for actuation and can also be set to a lowerhold-current via pulse-width modulation (PWM) to limit steady-statepower dissipation. Switching of the RF selection relays 3124 is achievedwith force guided (safety) relays and the status of the contact state issensed by the controller 3082 as a mitigation for any single faultconditions. In one aspect, the RF selection relays 3124 are configuredto be in a first state, where an output RF signal received from an RFsource, such as the wideband RF power amplifier 3108, is transmitted toa first component of the energy module 3004, such as the RF powertransformer 3110 of the bipolar energy receptacle 3118. In a secondaspect, the RF selection relays 3124 are configured to be in a secondstate, where an output RF signal received from an RF source, such as thewideband RF power amplifier 3108, is transmitted to a second component,such as an RF power transformer 3128 of a monopolar energy receptacle3136, described in more detail below. In a general aspect, the RFselection relays 3124 are configured to be driven by the controller 3082to switch between a plurality of states, such as the first state and thesecond state, to transmit the output RF signal received from the RFpower amplifier 3108 between different energy receptacles of the energymodule 3004.

As described above, the output of the wideband RF power amplifier 3108can also fed through the RF selection relays 3124 to the wideband RFpower transformer 3128 of the RF monopolar receptacle 3136. Monopolar RFvoltage (V) and current (I) feedback (FB) signals, which may be employedto compute RF impedance, are fed back to the controller 3082 via an RFVI FB transformer 3130 through an input portion of the monopolar RFenergy receptacle 3136. The RF voltage and current feedback signals arerouted back to the controller 3082 through an A/D 3126. Also coupled tothe controller 3082 through the monopolar RF energy receptacle 3136 isthe isolated DC/DC converter port 3132, which receives DC power from thepower bus 3006, and a low bandwidth data port 3134.

The output of the wideband RF power amplifier 3108 can also fed throughthe RF selection relays 3124 to the wideband RF power transformer 3090of the advanced energy receptacle 3100. RF voltage (V) and current (I)feedback (FB) signals, which may be employed to compute RF impedance,are fed back to the controller 3082 via an RF VI FB transformer 3094through an input portion of the advanced energy receptacle 3100. The RFvoltage and current feedback signals are routed back to the controller3082 through an A/D 3104.

FIG. 35 is a block diagram of a second energy module 3012 coupled to aheader module 3150, in accordance with at least one aspect of thepresent disclosure. The first energy module 3004 shown in FIG. 34 iscoupled to the second energy module 3012 shown in FIG. 35 by couplingthe second pass-through hub connector 3078 of the first energy module3004 to a first pass-through hub connector 3074 of the second energymodule 3012. In one aspect, the second energy module 3012 can a similarenergy module to the first energy module 3004, as is illustrated in FIG.35 . In another aspect, the second energy module 2012 can be a differentenergy module compared to the first energy module, such as an energymodule illustrated in FIG. 37 , described in more detail. The additionof the second energy module 3012 to the first energy module 3004 addsfunctionality to the modular energy system 3000.

The second energy module 3012 is coupled to the header module 3150 byconnecting the pass-through hub connector 3078 to the pass-through hubconnector 3152 of the header module 3150. In one aspect, the headermodule 3150 can include a header processor 3158 that is configured tomanage a power button function 3166, software upgrades through theupgrade USB module 3162, system time management, and gateway to externalnetworks (i.e., hospital or the cloud) via an Ethernet module 3164 thatmay be running different protocols. Data is received by the headermodule 3150 through the pass-through hub connector 3152. The headerprocessor 3158 also is coupled to a switch 3160 to receive, process, andforward data from the source device to the destination device andcontrol data communication therebetween. The header processor 3158 alsois coupled to an OTS power supply 3156 coupled to a mains power entrymodule 3154.

FIG. 36 is a block diagram of a header/user interface (UI) module 3002for a hub, such as the header module depicted in FIG. 33 , in accordancewith at least one aspect of the present disclosure. The header/UI module3002 includes a header power module 3172, a header wireless module 3174,a header USB module 3176, a header audio/screen module 3178, a headernetwork module 3180 (e.g., Ethernet), a backplane connector 3182, aheader standby processor module 3184, and a header footswitch module3186. These functional modules interact to provide the header/UI 3002functionality. A header/UI controller 3170 controls each of thefunctional modules and the communication therebetween including safetycritical control logic modules 3230, 3232 coupled between the header/UIcontroller 3170 and an isolated communications module 3234 coupled tothe header footswitch module 3186. A security co-processor 3188 iscoupled to the header/UI controller 3170.

The header power module 3172 includes a mains power entry module 3190coupled to an OTS power supply unit 3192 (PSU). Low voltage directcurrent (e.g., 5V) standby power is supplied to the header/UI module3002 and other modules through a low voltage power bus 3198 from the OTSPSU 3192. High voltage direct current (e.g., 60V) is supplied to theheader/UI module 3002 through a high voltage bus 3200 from the OTS PSU3192. The high voltage DC supplies DC/DC converter modules 3196 as wellas isolated DC/DC converter modules 3236. A standby processor 3204 ofthe header/standby module 3184 provides a PSU/enable signal 3202 to theOTS PSU 3192.

The header wireless module 3174 includes a WiFi module 3212 and aBluetooth module 3214. Both the WiFi module 3212 and the Bluetoothmodule 3214 are coupled to the header/UI controller 3170. The Bluetoothmodule 3214 is used to connect devices without using cables and theWi-Fi module 3212 provides high-speed access to networks such as theInternet and can be employed to create a wireless network that can linkmultiple devices such as, for examples, multiple energy modules or othermodules and surgical instruments, among other devices located in theoperating room. Bluetooth is a wireless technology standard that is usedto exchange data over short distances, such as, less than 30 feet.

The header USB module 3176 includes a USB port 3216 coupled to theheader/UI controller 3170. The USB module 3176 provides a standard cableconnection interface for modules and other electronics devices overshort-distance digital data communications. The USB module 3176 allowsmodules comprising USB devices to be connected to each other with andtransfer digital data over USB cables.

The header audio/screen module 3178 includes a touchscreen 3220 coupledto a touch controller 3218. The touch controller 3218 is coupled to theheader/UI controller 3170 to read inputs from the touchscreen 3220. Theheader/UI controller 3170 drives an LCD display 3224 through adisplay/port video output signal 3222. The header/UI controller 3170 iscoupled to an audio amplifier 3226 to drive one or more speakers 3228.

In one aspect, the header/UI module 3002 provides a touchscreen 3220user interface configured to control modules connected to one control orheader module 3002 in a modular energy system 3000. The touchscreen 3220can be used to maintain a single point of access for the user to adjustall modules connected within the modular energy system 3000. Additionalhardware modules (e.g., a smoke evacuation module) can appear at thebottom of the user interface LCD display 3224 when they become connectedto the header/UI module 3002, and can disappear from the user interfaceLCD display 3224 when they are disconnected from the header/UI module3002.

Further, the user touchscreen 3220 can provide access to the settings ofmodules attached to the modular energy system 3000. Further, the userinterface LCD display 3224 arrangement can be configured to changeaccording to the number and types of modules that are connected to theheader/UI module 3002. For example, a first user interface can bedisplayed on the LCD display 3224 for a first application where oneenergy module and one smoke evacuation module are connected to theheader/UI module 3002, and a second user interface can be displayed onthe LCD display 3224 for a second application where two energy modulesare connected to the header/UI module 3002. Further, the user interfacecan alter its display on the LCD display 3224 as modules are connectedand disconnected from the modular energy system 3000.

In one aspect, the header/UI module 3002 provides a user interface LCDdisplay 3224 configured to display on the LCD display coloringcorresponds to the port lighting. In one aspect, the coloring of theinstrument panel and the LED light around its corresponding port will bethe same or otherwise correspond with each other. Each color can, forexample, convey a unique meaning. This way, the user will be able toquickly assess which instrument the indication is referring to and thenature of the indication. Further, indications regarding an instrumentcan be represented by the changing of color of the LED light linedaround its corresponding port and the coloring of its module. Stillfurther, the message on screen and hardware/software port alignment canalso serve to convey that an action must be taken on the hardware, noton the interface. In various aspects, all other instruments can be usedwhile alerts are occurring on other instruments. This allows the user tobe able to quickly assess which instrument the indication is referringto and the nature of the indication.

In one aspect, the header/UI module 3002 provides a user interfacescreen configured to display on the LCD display 3224 to presentprocedure options to a user. In one aspect, the user interface can beconfigured to present the user with a series of options (which can bearranged, e.g., from broad to specific). After each selection is made,the modular energy system 3000 presents the next level until allselections are complete. These settings could be managed locally andtransferred via a secondary means (such as a USB thumb drive).Alternatively, the settings could be managed via a portal andautomatically distributed to all connected systems in the hospital.

The procedure options can include, for example, a list of factory presetoptions categorized by specialty, procedure, and type of procedure. Uponcompleting a user selection, the header module can be configured to setany connected instruments to factory-preset settings for that specificprocedure. The procedure options can also include, for example, a listof surgeons, then subsequently, the specialty, procedure, and type. Oncea user completes a selection, the system may suggest the surgeon'spreferred instruments and set those instrument's settings according tothe surgeon's preference (i.e., a profile associated with each surgeonstoring the surgeon's preferences).

In one aspect, the header/UI module 3002 provides a user interfacescreen configured to display on the LCD display 3224 critical instrumentsettings. In one aspect, each instrument panel displayed on the LCDdisplay 3224 of the user interface corresponds, in placement andcontent, to the instruments plugged into the modular energy system 3000.When a user taps on a panel, it can expand to reveal additional settingsand options for that specific instrument and the rest of the screen can,for example, darken or otherwise be de-emphasized.

In one aspect, the header/UI module 3002 provides an instrument settingspanel of the user interface configured to comprise/display controls thatare unique to an instrument and allow the user to increase or decreasethe intensity of its output, toggle certain functions, pair it withsystem accessories like a footswitch connected to header footswitchmodule 3186, access advanced instrument settings, and find additionalinformation about the instrument. In one aspect, the user can tap/selectan “Advanced Settings” control to expand the advanced settings drawerdisplayed on the user interface LCD display 3224. In one aspect, theuser can then tap/select an icon at the top right-hand corner of theinstrument settings panel or tap anywhere outside of the panel and thepanel will scale back down to its original state. In these aspects, theuser interface is configured to display on the LCD display 3224 only themost critical instrument settings, such as power level and power mode,on the ready/home screen for each instrument panel. This is to maximizethe size and readability of the system from a distance. In some aspects,the panels and the settings within can be scaled proportionally to thenumber of instruments connected to the system to further improvereadability. As more instruments are connected, the panels scale toaccommodate a greater amount of information.

The header network module 3180 includes a plurality of networkinterfaces 3264, 3266, 3268 (e.g., Ethernet) to network the header/UImodule 3002 to other modules of the modular energy system 3000. In theillustrated example, one network interface 3264 may be a 3rd partynetwork interface, another network interface 3266 may be a hospitalnetwork interface, and yet another network interface 3268 may be locatedon the backplane network interface connector 3182.

The header standby processor module 3184 includes a standby processor3204 coupled to an On/Off switch 3210. The standby processor 3204conducts an electrical continuity test by checking to see if electricalcurrent flows in a continuity loop 3206. The continuity test isperformed by placing a small voltage across the continuity loop 3206. Aserial bus 3208 couples the standby processor 3204 to the backplaneconnector 3182.

The header footswitch module 3186 includes a controller 3240 coupled toa plurality of analog footswitch ports 3254, 3256, 3258 through aplurality of corresponding presence/ID and switch state modules 3242,3244, 3246, respectively. The controller 3240 also is coupled to anaccessory port 3260 via a presence/ID and switch state module 3248 and atransceiver module 3250. The accessory port 3260 is powered by anaccessory power module 3252. The controller 3240 is coupled to header/UIcontroller 3170 via an isolated communication module 3234 and first andsecond safety critical control modules 3230, 3232. The header footswitchmodule 3186 also includes DC/DC converter modules 3238.

In one aspect, the header/UI module 3002 provides a user interfacescreen configured to display on the LCD display 3224 for controlling afootswitch connected to any one of the analog footswitch ports 3254,3256, 3258. In some aspects, when the user plugs in a non hand-activatedinstrument into any one of the analog footswitch ports 3254, 3256, 3258,the instrument panel appears with a warning icon next to the footswitchicon. The instrument settings can be, for example, greyed out, as theinstrument cannot be activated without a footswitch.

When the user plugs in a footswitch into any one of the analogfootswitch ports 3254, 3256, 3258, a pop-up appears indicating that afootswitch has been assigned to that instrument. The footswitch iconindicates that a footswitch has been plugged in and assigned to theinstrument. The user can then tap/select on that icon to assign,reassign, unassign, or otherwise change the settings associated withthat footswitch. In these aspects, the system is configured toautomatically assign footswitches to non hand-activated instrumentsusing logic, which can further assign single or double-pedalfootswitches to the appropriate instrument. If the user wants toassign/reassign footswitches manually there are two flows that can beutilized.

In one aspect, the header/UI module 3002 provides a global footswitchbutton. Once the user taps on the global footswitch icon (located in theupper right of the user interface LCD display 3224), the footswitchassignment overlay appears and the contents in the instrument modulesdim. A (e.g., photo-realistic) representation of each attachedfootswitch (dual or single-pedal) appears on the bottom if unassigned toan instrument or on the corresponding instrument panel. Accordingly, theuser can drag and drop these illustrations into, and out of, the boxedicons in the footswitch assignment overlay to assign, unassign, andreassign footswitches to their respective instruments.

In one aspect, the header/UI module 3002 provides a user interfacescreen displayed on the LCD display 3224 indicating footswitchauto-assignment, in accordance with at least one aspect of the presentdisclosure. As discussed above, the modular energy system 3000 can beconfigured to auto-assign a footswitch to an instrument that does nothave hand activation. In some aspects, the header/UI module 3002 can beconfigured to correlate the colors displayed on the user interface LCDdisplay 3224 to the lights on the modules themselves as means oftracking physical ports with user interface elements.

In one aspect, the header/UI module 3002 may be configured to depictvarious applications of the user interface with differing number ofmodules connected to the modular energy system 3000. In various aspects,the overall layout or proportion of the user interface elementsdisplayed on the LCD display 3224 can be based on the number and type ofinstruments plugged into the header/UI module 3002. These scalablegraphics can provide the means to utilize more of the screen for bettervisualization.

In one aspect, the header/UI module 3002 may be configured to depict auser interface screen on the LCD display 3224 to indicate which ports ofthe modules connected to the modular energy system 3000 are active. Insome aspects, the header/UI module 3002 can be configured to illustrateactive versus inactive ports by highlighting active ports and dimminginactive ports. In one aspect, ports can be represented with color whenactive (e.g., monopolar tissue cut with yellow, monopolar tissuecoagulation with blue, bipolar tissue cut with blue, advanced energytissue cut with warm white, and so on). Further, the displayed colorwill match the color of the light piping around the ports. The coloringcan further indicate that the user cannot change settings of otherinstruments while an instrument is active. As another example, theheader/UI module 3002 can be configured to depict the bipolar,monopolar, and ultrasonic ports of a first energy module as active andthe monopolar ports of a second energy module as likewise active.

In one aspect, the header/UI module 3002 can be configured to depict auser interface screen on the LCD display 3224 to display a globalsettings menu. In one aspect, the header/UI module 3002 can beconfigured to display a menu on the LCD display 3224 to control globalsettings across any modules connected to the modular energy system 3000.The global settings menu can be, for example, always displayed in aconsistent location (e.g., always available in upper right hand cornerof main screen).

In one aspect, the header/UI module 3002 can be configured to depict auser interface screen on the LCD display 3224 configured to preventchanging of settings while a surgical instrument is in use. In oneexample, the header/UI module 3002 can be configured to prevent settingsfrom being changed via a displayed menu when a connected instrument isactive. The user interface screen can include, for example, an area(e.g., the upper left hand corner) that is reserved for indicatinginstrument activation while a settings menu is open. In one aspect, auser has opened the bipolar settings while monopolar coagulation isactive. In one aspect, the settings menu could then be used once theactivation is complete. In one aspect, the header/UI module 3002 can beis configured to never overlay any menus or other information over thededicated area for indicating critical instrument information in orderto maintain display of critical information.

In one aspect, the header/UI module 3002 can be configured to depict auser interface screen on the LCD display 3224 configured to displayinstrument errors. In one aspect, instrument error warnings may bedisplayed on the instrument panel itself, allowing user to continue touse other instruments while a nurse troubleshoots the error. This allowsusers to continue the surgery without the need to stop the surgery todebug the instrument.

In one aspect, the header/UI module 3002 can be configured to depict auser interface screen on the LCD display 3224 to display different modesor settings available for various instruments. In various aspects, theheader/UI module 3002 can be configured to display settings menus thatare appropriate for the type or application of surgical instrument(s)connected to the stack/hub. Each settings menu can provide options fordifferent power levels, energy delivery profiles, and so on that areappropriate for the particular instrument type. In one aspect, theheader/UI module 3002 can be configured to display different modesavailable for bipolar, monopolar cut, and monopolar coagulationapplications.

In one aspect, the header/UI module 3002 can be configured to depict auser interface screen on the LCD display 3224 to display pre-selectedsettings. In one aspect, the header/UI module 3002 can be configured toreceive selections for the instrument/device settings before plugging ininstruments so that the modular energy system 3000 is ready before thepatient enters the operating room. In one aspect, the user can simplyclick a port and then change the settings for that port. In the depictedaspect, the selected port appears as faded to indicate settings are set,but no instrument is plugged into that port.

FIG. 37 is a block diagram of an energy module 3270 for a hub, such asthe energy module depicted in FIGS. 31, 32, 34, and 35 , in accordancewith at least one aspect of the present disclosure. The energy module3270 is configured to couple to a header module, header/UI module, andother energy modules via the first and second pass-through hubconnectors 3272, 3276. A switch 3076 disposed between the first andsecond pass-through hub connectors 3272, 3276 receives, processes, andforwards data from the source device to the destination device andcontrols data communication therebetween. Data is received andtransmitted through the data bus 3008. The energy module 3270 includes acontroller 3082 to control various communications and processingfunctions of the energy module 3270.

DC power is received and transmitted by the energy module 3270 throughthe power bus 3006. The power bus 3006 is coupled to the DC/DC convertermodules 3138 to supply power to adjustable regulators 3084, 3107 andisolated DC/DC converter ports 3096, 3112, 3132.

In one aspect, the energy module 3270 can include an ultrasonic widebandamplifier 3086, which in one aspect may be a linear class H amplifierthat is capable of generating arbitrary waveforms and drive harmonictransducers at low total harmonic distortion (THD) levels. Theultrasonic wideband amplifier 3086 is fed by a buck adjustable regulator3084 to maximize efficiency and controlled by the controller 3082, whichmay be implemented as a digital signal processor (DSP) via a directdigital synthesizer (DDS), for example. The DDS can either be embeddedin the DSP or implemented in the field-programmable gate array (FPGA),for example. The controller 3082 controls the ultrasonic widebandamplifier 3086 via a digital-to-analog converter 3106 (DAC). The outputof the ultrasonic wideband amplifier 3086 is fed to an ultrasonic powertransformer 3088, which is coupled to an ultrasonic energy outputportion of the advanced energy receptacle 3100. Ultrasonic voltage (V)and current (I) feedback (FB) signals, which may be employed to computeultrasonic impedance, are fed back to the controller 3082 via anultrasonic VI FB transformer 3092 through an input portion of theadvanced energy receptacle 3100. The ultrasonic voltage and currentfeedback signals are routed back to the controller 3082 through ananalog multiplexer 3280 and a dual analog-to-digital converter 3278(A/D). In one aspect, the dual A/D 3278 has a sampling rate of 80 MSPS.Also coupled to the controller 3082 through the advanced energyreceptacle 3100 is the isolated DC/DC converter port 3096, whichreceives DC power from the power bus 3006, and a medium bandwidth dataport 3098.

In one aspect, the energy module 3270 can include a plurality ofwideband RF power amplifiers 3108, 3286, 3288, among others, which inone aspect, each of the wideband RF power amplifiers 3108, 3286, 3288may be linear class H amplifiers capable of generating arbitrarywaveforms and drive RF loads at a range of output frequencies. Each ofthe wideband RF power amplifiers 3108, 3286, 3288 are fed by anadjustable buck regulator 3107 to maximize efficiency and controlled bythe controller 3082, which may be implemented as DSP via a DDS. The DDScan either be embedded in the DSP or implemented in the FPGA, forexample. The controller 3082 controls the first wideband RF poweramplifier 3108 via a DAC 3122.

Unlike the energy modules 3004, 3012 shown and described in FIGS. 34 and35 , the energy module 3270 does not include RF selection relaysconfigured to receive an RF output signal from the adjustable buckregulator 3107. In addition, unlike the energy modules 3004, 3012 shownand described in FIGS. 34 and 35 , the energy module 3270 includes aplurality of wideband RF power amplifiers 3108, 3286, 3288 instead of asingle RF power amplifier. In one aspect, the adjustable buck regulator3107 can switch between a plurality of states, in which the adjustablebuck regulator 3107 outputs an output RF signal to one of the pluralityof wideband RF power amplifiers 3108, 3286, 3288 connected thereto. Thecontroller 3082 is configured to switch the adjustable buck regulator3107 between the plurality of states. In a first state, the controllerdrives the adjustable buck regulator 3107 to output an RF energy signalto the first wideband RF power amplifier 3108. In a second state, thecontroller drives the adjustable buck regulator 3107 to output an RFenergy signal to the second wideband RF power amplifier 3286. In a thirdstate, the controller drives the adjustable buck regulator 3107 tooutput an RF energy signal to the third wideband RF power amplifier3288.

The output of the first wideband RF power amplifier 3108 can be fed toan RF power transformer 3090, which is coupled to an RF output portionof an advanced energy receptacle 3100. RF voltage (V) and current (I)feedback (FB) signals, which may be employed to compute RF impedance,are fed back to the controller 3082 via RF VI FB transformers 3094through an input portion of the advanced energy receptacle 3100. The RFvoltage and current feedback signals are routed back to the controller3082 through the RF VI FB transformers 3094, which are coupled to ananalog multiplexer 3284 and a dual A/D 3282 coupled to the controller3082. In one aspect, the dual A/D 3282 has a sampling rate of 80 MSPS.

The output of the second RF wideband power amplifier 3286 is fed throughan RF power transformer 3128 of the RF monopolar receptacle 3136.Monopolar RF voltage (V) and current (I) feedback (FB) signals, whichmay be employed to compute RF impedance, are fed back to the controller3082 via RF VI FB transformers 3130 through an input portion of themonopolar RF energy receptacle 3136. The RF voltage and current feedbacksignals are routed back to the controller 3082 through the analogmultiplexer 3284 and the dual A/D 3282. Also coupled to the controller3082 through the monopolar RF energy receptacle 3136 is the isolatedDC/DC converter port 3132, which receives DC power from the power bus3006, and a low bandwidth data port 3134.

The output of the third RF wideband power amplifier 3288 is fed throughan RF power transformer 3110 of a bipolar RF receptacle 3118. Bipolar RFvoltage (V) and current (I) feedback (FB) signals, which may be employedto compute RF impedance, are fed back to the controller 3082 via RF VIFB transformers 3114 through an input portion of the bipolar RF energyreceptacle 3118. The RF voltage and current feedback signals are routedback to the controller 3082 through the analog multiplexer 3280 and thedual A/D 3278. Also coupled to the controller 3082 through the bipolarRF energy receptacle 3118 is the isolated DC/DC converter port 3112,which receives DC power from the power bus 3006, and a low bandwidthdata port 3116.

A contact monitor 3290 is coupled to an NE receptacle 3292. Power is fedto the NE receptacle 3292 from the monopolar receptacle 3136.

In one aspect, with reference to FIGS. 31-37 , the modular energy system3000 can be configured to detect instrument presence in a receptacle3100, 3118, 3136 via a photo-interrupter, magnetic sensor, or othernon-contact sensor integrated into the receptacle 3100, 3118, 3136. Thisapproach prevents the necessity of allocating a dedicated presence pinon the MTD connector to a single purpose and instead allowsmulti-purpose functionality for MTD signal pins 6-9 while continuouslymonitoring instrument presence.

In one aspect, with reference to FIGS. 31-37 , the modules of themodular energy system 3000 can include an optical link allowing highspeed communication (10-50 Mb/s) across the patient isolation boundary.This link would carry device communications, mitigation signals(watchdog, etc.), and low bandwidth run-time data. In some aspects, theoptical link(s) will not contain real-time sampled data, which can bedone on the non-isolated side.

In one aspect, with reference to FIGS. 31-37 , the modules of themodular energy system 3000 can include a multi-function circuit blockwhich can: (i) read presence resistor values via A/D and current source,(ii) communicate with legacy instruments via hand switch Q protocols,(iii) communicate with instruments via local bus 1-Wire protocols, and(iv) communicate with CAN FD-enabled surgical instruments. When asurgical instrument is properly identified by an energy generatormodule, the relevant pin functions and communications circuits areenabled, while the other unused functions are disabled and set to a highimpedance state.

In one aspect, with reference to FIGS. 31-37 , the modules of themodular energy system 3000 can include an amplifierpulse/stimulation/auxiliary DC amplifier. This is a flexible-useamplifier based on a full-bridge output and incorporates functionalisolation. This allows its differential output to be referenced to anyoutput connection on the applied part (except, in some aspects, amonopolar active electrode). The amplifier output can be either smallsignal linear (pulse/stim) with waveform drive provided by a DAC or asquare wave drive at moderate output power for DC applications such asDC motors, illumination, FET drive, etc. The output voltage and currentare sensed with functionally isolated voltage and current feedback toprovide accurate impedance and power measurements to the FPGA. Pairedwith a CAN FD-enabled instrument, this output can offer motor/motioncontrol drive, while position or velocity feedback is provided by theCAN FD interface for closed loop control.

Energy Module Hardware

Some surgical procedures require the use of multiple different types ofenergy modalities. One option is to utilize multiple different surgicalsystems that are each configured to deliver one type of energy modalityand switch between the surgical systems as needed during the course ofthe surgical procedure. However, in addition to the general convenienceof having multiple different energy modalities available through asingle system, a surgical system that is configured to delivercombinations of different energy modalities can provide a number ofbenefits and improved functionality over surgical systems that areconfigured to deliver a singular energy modality. For example,simultaneously delivering combinations of energy modalities can provideimproved tissue coagulation as compared to a single energy modality. Asanother example, monopolar surgical systems can have issues with tissueadherence to the tip of the monopolar electrosurgical instrument.However, a surgical system configured to deliver both monopolar andultrasonic energy can reduce tissue adherence to the surgical instrumentwhen delivering monopolar energy by vibrating the end effector as energyis delivered. As yet another example, a surgical system configured todeliver monopolar energy in addition to other energy modalities canallow for the monopolar energy to be utilized as a supplement for thesystem's other energy modality, which can be useful for “touch up”coagulation. Accordingly, in various aspects, a surgical systemconfigured to deliver multiple energy modalities can be configured todeliver bipolar, monopolar, and/or ultrasonic energy. Surgical systemsthat are configured to deliver combinations of energy modalities canfurther include a surgical generator or energy module that can delivermultiple energy modalities to the surgical instrument via a single port,thereby allowing a single surgical instrument to simultaneously oralternatively utilize the different energy modalities.

In various aspects, the present disclosure provides an amplifier circuitand port arrangement within a single energy module configured to deliversignals to surgical devices. The port is coupled to two separatemonopolar energy sources, one bipolar energy source, and one advancedenergy source, which includes, bipolar energy mode, monopolar energymode, and ultrasonic energy mode. In a further aspect, the presentdisclosure provides an energy source connector that includes a pinarrangement configured to deliver bipolar energy, monopolar energy, andultrasonic energy, where the monopolar pin has a different pin size andspacing from the other pins to prevent electrical arcing and shortingbetween pins. In yet a further aspect, the present disclosure provides aleakage current detection circuit on each port on an energy source tomonitor for stray energy, which can be used to shut off an unwantedenergy path.

As described above in connection with FIGS. 21, 22, 24-30, and 33-37 ,an energy module 2004 can be configured to provide a variety ofdifferent energy modalities. For example, FIG. 38 is a block diagram ofan energy module circuit 9000 for an energy module 2004 that isconfigured to deliver multiple energy modalities to a surgicalinstrument connected to the energy module 2004. The energy modulecircuit 9000 includes an energy drive assembly 9001 that is configuredto generate the electrical signals for driving the various energymodalities applied by the surgical instrument connected to the energymodule 2004. The energy drive assembly 9001 can include variouscircuitry and/or other hardware components for generating, controlling,and delivering drive signals for driving monopolar electrosurgicalenergy, bipolar electrosurgical energy, ultrasonic energy, or otherenergy modalities, and combinations thereof, at a surgical instrumentcoupled to the energy module 2004. In this particular example, theenergy drive assembly 9001 includes a first amplifier 9002 configured todrive a first energy modality, a second amplifier 9004 configured todrive a second energy modality, a third amplifier 9006 configured todrive a third energy modality, and a fourth amplifier 9008 configured todrive a fourth energy modality. The amplifiers 9002, 9004, 9006, 9008can be configured to drive the same or different energy modalities. Thevarious amplifiers 9002, 9004, 9006, 9008 can include an ultrasonicamplifier capable of generating arbitrary waveforms to drive ultrasonictransducers at low total harmonic distortion (THD) levels and/or abipolar and/or monopolar electrosurgical amplifier capable of generatingarbitrary waveforms to drive RF loads at a range of output frequencies.The waveforms generated by the various amplifier types can also bereferred to as “drive signals” for the different energy modality types.Further, such amplifiers can include linear or resonant amplifiers. Inone particular implementation of the energy module circuit 9000, thefirst amplifier 9002 can include an ultrasonic amplifier, the secondamplifier 9004 can include a bipolar electrosurgical amplifier, thethird amplifier 9006 can include a monopolar electrosurgical amplifier,and the fourth amplifier 9008 can include another bipolarelectrosurgical amplifier. However, the energy drive assembly 9001 caninclude other numbers and combinations of amplifiers, such as with theenergy module 3004 shown in FIG. 34 , for example. Further, the energydrive assembly 9001 can include a variety of other circuit components,such as is described in connection with the energy modules 3004, 3270shown in FIGS. 34, 35, and 37 .

The energy module circuit 9000 further includes a receptacle or portassembly 9011 that is electrically coupled to the energy drive assembly9001. In this particular example, the port assembly 9011 includes afirst port 9020, a second port 9022, a third port 9024, a fourth port9026, and a fifth port 9028. The ports 9020, 9022, 9024, 9026, 9028(which can also be referred to as receptacles) can be configured to, forexample, receive or engage with corresponding connectors associated withsurgical instruments (or cables to which the surgical instruments areconnected) or connectors for an energy module/surgical system accessory(e.g., a monopolar return pad). In this particular example, the firstport 9020 is electrically coupled or couplable to each of the firstamplifier 9002, the second amplifier 9004, and the third amplifier 9006and is thus capable of delivering up to three different energymodalities, one of which is driven by each of the respective amplifiers9002, 9004, 9006. The second port 9022 and the third port 9024 are eachelectrically coupled to the third amplifier 9006 and are thus capable ofdelivering the same energy modality driven therefrom. The fourth port9026 is electrically coupled to an electrical ground for the thirdamplifier 9006 and thus serves as an electrical return path for theenergy modality driven by the third amplifier 9006 through at least oneof the first, second, or third ports 9020, 9022, 9024. For example, thefourth port 9026 can serve as a connection point for a monopolar returnpad for aspects where the third amplifier 9006 is a monopolar amplifier(as a monopolar electrosurgical instrument, as opposed to a bipolarelectrosurgical instrument, must be used in connection with a monopolarreturn pad). The fifth port 9028 is electrically coupled to the fourthamplifier 9008 and is thus capable of delivering an energy modalitydriven therefrom.

In one aspect, the energy module circuit 9000 can be divided into amultiple isolated circuit portions or stages. Each of the circuitportions can be electrically isolated from the other circuit portionsfor safety purposes and compliance with electrosurgical generatortechnical standards, such as IEC 60601. Each of the isolated circuitportions can be coupled to the energy drive assembly 9001 via one ormore isolation transformers. An isolation transformer is utilized totransfer electrical power from a source of AC power to a recipientdevice, in this case, the isolated circuit portions, while isolating therecipient device from the power source. Further, the isolated circuitportions can include one or more local grounds for electricallyisolating the components of the energy drive assembly 9001 correspondingto that circuit portion from the components corresponding to the othercircuit portions. Accordingly, each of the circuit portions areelectrically isolated from each other. In the particular implementationillustrated in FIG. 38 , the energy module circuit 9000 includes a firstisolated circuit portion 9012 corresponding to the first port 9020, asecond isolated circuit portion 9014 corresponding to the second andthird ports 9022, 9024, a third isolated circuit portion 9016corresponding to the fourth port 9026, and a fourth isolated circuitportion 9018 corresponding to the fifth port 9028. The first isolatedcircuit portion 9012 is coupled to the first and second amplifiers 9002,9004 via a first isolation transformer 9050 a and a second isolationtransformer 9050 b, respectively. The first isolated circuit portion9012 is further couplable to the third amplifier 9006, through theswitch assembly 9030, via a third isolation transformer 9050 c. Thesecond isolated circuit portion 9014 is coupled to the third amplifier9006 via the third isolation transformer 9050 c. The third isolatedcircuit portion 9016 is coupled to the return terminal of the thirdisolation transformer 9050 c. Lastly, the fourth isolated circuitportion 9018 is coupled to the fourth amplifier 9008 via a fourthisolation transformer 9050 d. Further, the first isolated circuitportion 9012 includes a first isolated local ground 9029 a and a secondisolated local ground 9029 b for the first isolation transformer 9050 aand the second isolation transformer 9050 b, respectively. The fourthisolated circuit portion 9018 includes a third isolated local ground9029 c for the fourth isolation transformer 9050 d. The third isolatedcircuit portion 9016 is electrically isolated from the other circuitportions 9012, 9014, 9018 via the connection between the fourth port9026 and the return terminal of the third isolation transformer 9050 c.The fourth port 9026 can likewise, in part, serve the electricalisolation of the first isolated circuit portion 9012 when the firstswitch 9032 a is in its closed state and the first port 9020 is coupledto the third amplifier 9006 through the third isolation transformer 9050c. In addition to generally seeking to comply with applicable technicalstandards, dividing the energy module circuit 9000 into multipleisolated circuit portions 9012, 9014, 9016, 9018 in this manner ensuresthat surgical components that are intended to come into contact withpatients are not inadvertently energized when other components orcircuits are energized, which, in turn, promotes patient and operatorsafety.

It should be noted that the particular implementation of the energymodule circuit 9000 illustrated in FIG. 38 for an energy module 3004 isonly provided for illustrative purposes. Various other arrangements orcombinations of amplifiers 9002, 9004, 9006, 9008 within the energydrive assembly 9001, isolated circuit portions 9012, 9014, 9016, 9018,and/or ports 9020, 9022, 9024, 9026, 9028 are within the scope of thepresent disclosure, including different numbers or amplifiers 9002,9004, 9006, 9008 or amplifiers 9002, 9004, 9006, 9008 that drivedifferent combinations of energy modalities, isolated circuit portions9012, 9014, 9016, 9018 that include different combinations of componentsor are otherwise arranged in different manners, and so on.

As described above, in one aspect, the energy module circuit 9000 caninclude a circuit (e.g., the first isolated circuit portion 9012 and/orother associated components, such as the first, second, and thirdamplifiers 9002, 9004, 9006) that is configured to deliver multipledifferent energy modalities to a surgical instrument connected to theport (e.g., the first port 9020) associated with the particular circuit.In one aspect, a surgical instrument receiving multiple energy drivesignals can be configured to simultaneously or individually apply thedriven energy modalities to tissue. In another aspect, such a surgicalinstrument can be configured to utilize one or more of the driven energymodalities for non-tissue treatment purposes, such as sensing or fordriving secondary functions of the surgical instrument. For example, adrive signal from a bipolar amplifier (e.g., the second amplifier 9004)can be driven at nontherapeutic frequencies (i.e., below the minimumfrequency necessary to induce treatment effects in tissue to which thesignal is applied) for sensing various tissue properties, such as tissuethickness or tissue type. As another signal, a drive signal from anultrasonic amplifier (e.g., the first amplifier 9002) can be driven atnontherapeutic frequencies to vibrate an end effector to prevent tissueadhesion thereto as monopolar or bipolar energy is applied to tissue toprevent tissue adhesion to the end effector. In yet another aspect,energy module drive signals can be utilized to power secondary ornontherapeutic components of connected surgical instruments, as isdescribed hereinbelow.

Because of the significant number of hardware components required by theenergy modules 2004 described herein for driving all of the variouscombinations of energy modalities, it would generally be desirable toutilize hardware components for multiple different purposes within theenergy modules 2004 in order to minimize the hardware footprint of theenergy modules 2004. In one aspect, one or more amplifiers of the energydriver assembly 9001 can be interchangeably couplable to one or moreports of the port assembly 9011 via a switch assembly 9030. In thisparticular example, the third amplifier 9006 is interchangeablycouplable to each of the first port 9020, the second port 9022, and thethird port 9024 via the switch assembly 9030. The switch assembly 9030includes a first switch 9032 a for coupling the third amplifier 9006 tothe first port 9020, a second switch 9032 b for coupling the thirdamplifier 9006 to the second port 9022, and a third switch 9032 c forcoupling the third amplifier 9006 to the third port 9024. Each of theswitches 9032 a, 9032 b, 9032 c can be transitioned between an openposition/state in which the third amplifier 9006 is decoupled from therespective port 9020, 9022, 9024 and a closed position/state in whichthe third amplifier 9006 is coupled to the respective port 9020, 9022,9024. Accordingly, the third amplifier 9006 can be configured togenerate an electrical drive signal for driving its respective energymodality, which can be provided to a surgical instrument through thefirst port 9020, the second port 9022, and/or the third port 9024according to which of the respective switches 9032 a, 9032 b, 9032 c isin its closed position or state. In various aspects, the switch assembly9030 can be controlled by a control circuit 9010, which is describedfurther below, to selectively control which of the ports 9020, 9022,9024 the third amplifier 9006 is coupled to. Further, FIG. 39illustrates a circuit diagram providing additional detail regarding thecircuit architecture of the third amplifier 9006 and the switch assembly9030. Utilizing a switching assembly 9030 to interchangeably connect anamplifier from the energy driver assembly 9001 to multiple portsutilizing the same energy modality, as opposed to dedicating a uniqueamplifier configured to drive the appropriate energy modality to eachport, simplifies the internal structure of the energy module 3004 byreusing the third amplifier 9006 across multiple ports. Reusing thethird amplifier 9006, in turn, reduces cost and saves space within theenergy module 3004. Further, the illustrated circuit architectureeliminates the need for relays to be integrated within the circuitpathway for the neutral electrode port (i.e., the fourth port 9026 inthe particular example illustrated in FIG. 38 ) because a single neutralelectrode pathway can be dedicated to the monopolar energy-providingthird amplifier 9006.

For operator and patient safety purposes, it is desirable for surgicalgenerator/energy systems having multiple monopolar ports (such as withthe energy module 3004 described above) to include systems to ensurethat the monopolar energy is only driven to the intended monopolarport/instrument. In one aspect, the energy module circuit 9000 canfurther include a leakage current detector circuit 9060 coupled to eachof the ports 9020, 9022, 9024 to which the switch assembly 9030 isconfigured to interchangeably couple the third amplifier 9006 (which, inthe example described above, is configured to provide a monopolar drivesignal). The leakage current detector circuit 9060 can be embodied asone or multiple circuit portions that are included within or coupled tothe electrical pathways for the ports 9020, 9022, 9024. The leakagecurrent detector circuit 9060 can be configured to determine whethermonopolar energy/drive signal is being inadvertently transmitted fromthe third amplifier 9006 to the respective port 9020, 9022, 9024. In oneaspect, the leakage current detector circuit 9060 can be coupled to eachpathway for the first, second, and third pots 9020, 9022, 9024 via arespective current sensing transformer 9062 a, 9062 b, 9062 c. As can beseen in FIG. 40 , the leakage current detector circuit 9060 can receiveas input a first sensed electrical current (MPA_IS) corresponding to themonopolar output current (MPA) transmitted to the first port 9020, asecond sensed electrical current (MPB_IS) corresponding to the monopolaroutput current (MPB) transmitted to the second port 9022, a third sensedelectrical current (MPC_IS) corresponding to the monopolar outputcurrent (MPC) transmitted to the third port 9024, and a referencecurrent (MP_IREF). The leakage current detector circuit 9060 can furtherinclude a pass/fail comparator 9064 a, 9064 b, 9064 c for each of thecurrent sensing transformer 9062 a, 9062 b, 9062 c. Each of thepass/fail comparators 9064 a, 9064 b, 9064 c is configured to change itsoutput state according to whether it senses a monopolar output. Theoutput of the leakage current detector circuit 9060 can include one ormore signals (labeled: MPA_MPCTRL_I_LEAK, MPB_MPCTRL_I_LEAK, andMPC_MPCTRL_I_LEAK) that are output by the pass/fail comparator 9064 a,9064 b, 9064 c according to their states. The output signals can eachindicate whether the port 9020, 9022, 9024 to which the output signalcorresponds is receiving monopolar output (i.e., a monopolar drivesignal), which can in turn be utilized to determine whether any of theports 9020, 9022, 9024 are inadvertently receiving monopolar output.These output signals from the comparators 9064 a, 9064 b, 9064 c can becommunicated to the control circuit 9010, which can then control thethird amplifier 9006 and/or switch assembly 9030 based upon whetherleakage current is detected. For example, when a leakage current isdetected, the control circuit 9010 can cause the third amplifier 9006 tocease outputting the drive signal. As another example, when a leakagecurrent is detected, the control circuit 9010 can cause the switchassembly 9030 to transition the appropriate switch 9032 a, 9032 b, 9032c to its closed position/state to halt the unintended delivery of thedrive signal to the port 9020, 9022, 9024 at which the leakage currentwas detected.

As noted above, the energy module circuit 9000 can further include acontrol circuit 9010 that is communicably coupled to the energy driveassembly 9001, the switch assembly 9030, and/or the leakage currentdetector circuit 9060. The control circuit 9010 can further becommunicably coupled to a bus 9040 for transmitting and receivinginformation/signals to and from other modules with a modular energysystem 3000 (FIGS. 31-37 ) or external systems, as is described in FIG.34 . In one aspect, the control circuit 9010 can include the controller3082 described in connection with FIGS. 33-37 . The control circuit 9010can further be configured to execute various algorithms or processes forcontrolling the energy module 3004.

In one aspect, the control circuit 9010 can be configured to monitor theenergy module circuit 9000 to determine when monopolar energy isinadvertently being applied to one or more ports of the energy module3004. For example, the control circuit 9010 can be configured to executethe process 9200 illustrated in FIG. 41 . The process 9200 can beembodied as, for example, instructions stored in a memory coupled to thecontrol circuit 9010 that, when executed by the control circuit 9010,cause the control circuit 9010 to perform the enumerated steps of theprocess 9200. In the following description of the process 9200,reference should also be made to FIGS. 38-40 .

Accordingly, the control circuit 9010 executing the process 9200activates 9202 monopolar energy for delivery to one of the ports of theport assembly 9011. For example, the control circuit 9010 can cause amonopolar amplifier of the energy module 3004 (e.g., the third amplifier9006) to generate a monopolar electrosurgical drive signal, which isdelivered by the isolation transformer 9050 c to the patient-isolatedside of the energy module circuit 9000, then through the switch assembly9030 to one of the ports 9020, 9022, 9024.

Accordingly, the control circuit 9010 determines 9204 whether the portto which the monopolar electrosurgical drive signal is intended to bedriven changes state. As discussed above, in one aspect, the controlcircuit 9010 can receive a signal from the comparators 9064 a, 9064 b,9064 c of the leakage current detector circuit 9060 corresponding to theintended port. If the received signal indicates that energy is not beingapplied to the intended port, then the process 9200 can proceed alongthe NO branch and the control circuit 9010 determines 9206 that a faultcondition has occurred because the port that is intended to be energizedis not in fact being energized. If the received signal indicates thatenergy is being applied to the intended port, then the process 9200 canproceed along the YES branch and the control circuit 9010 determines9208 whether another port configured to delivery monopolar energy haschanged state. In other words, the control circuit 9010 determines 9208whether the ports couplable to the monopolar amplifier via the switchassembly 9030, other than the intended port, are being energized by themonopolar amplifier. As discussed above, the control circuit 9010 canlikewise receive signals from the comparators 9064 a, 9064 b, 9064 c ofthe leakage current detector circuit 9060 that correspond to the otherports coupled to the switch assembly 9030. If the received signal(s)indicate(s) that energy is being applied to the other ports, then theprocess 9200 can proceed along the YES branch and the control circuit9010 determines 9206 that a fault condition has occurred because atleast one port is being inadvertently energized with monopolar energy.If the received signal(s) indicate(s) that energy is not being appliedto the other ports, then the process 9200 can proceed along the NObranch and the control circuit 9010 determines 9210 that the energymodule 3004 is operating normally.

In the event that the control circuit 9010 executing the process 9200determines 9206 that a fault condition has occurred, the control circuit9010 can take a variety of different actions, including providing analert to the user (e.g., via the display 2006 in FIGS. 24-30 ) ordeactivating the energy drive assembly 9001 or a component thereof(e.g., the monopolar amplifier).

In other aspects, a control circuit 9010 can be configured to controlthe energy module 3004 in a variety of other ways. For example, acontrol circuit 9010 can be configured to control the power level of orwaveform generated by the energy drive assembly 9001, the switchassembly 9030 to selectively couple or decouple the monopolar amplifierto one or more ports, and/or various other components of the energymodule 3004 based on sensed parameters.

As noted above, the energy module circuit 9000 can be delineated intomultiple isolated circuit portions 9012, 9014, 9016, 9018. Further, thefirst and second isolated circuit portions 9012, 9014 could, via theswitch assembly 9030, potentially be both coupled to the same amplifier(i.e., the third amplifier 9006). As the isolated circuit portions 9012,9014, 9016, 9018 are intended to be electrically isolated from eachother, it can be beneficial to ensure that only one of the first andsecond isolated circuit portions 9012, 9014 is coupled to the thirdamplifier 9006 at any given time. In one aspect, the control circuit9010 can be configured to control the relay 9030 such that only one ofthe first and second isolated circuit portions 9012, 9014 is coupled tothe third amplifier 9006 at any given time. For example, the controlcircuit 9010 can be configured to detect the position/state of each ofthe switches 9032 a, 9032 b, 9032 c. If the control circuit 9010determines that the first switch 9032 a has transitioned from its openposition/state to its closed position/state, then in response, thecontrol circuit 9010 can control the switch assembly 9030 to transitionthe second and third switches 9032 b, 9032 c to their openposition/state. Correspondingly, if the control circuit 9010 determinesthat at least one of the second or third switches 9032 b, 9032 c hastransitioned from its open position/state to its closed position/state,then in response, the control circuit 9010 can control the switchassembly 9030 to transition the first switch 9032 a to its openposition/state. As another example, the control circuit 9010 can monitorthe leakage current detector circuit 9060 to determine which ports arereceiving monopolar output, as is described above, and then control therelay assembly 9030 accordingly to ensure that only the first port 9020or the second and third ports 9022, 9024 are coupled to the thirdamplifier 9006.

As described in various aspects above, the first port 9020 can beconfigured to deliver a combination of different energy modalities.Accordingly, as illustrated in FIG. 42 , the first port 9020 can includea pin arrangement comprising a number of electrical pins or contacts9102 a-j that are positioned to engage with corresponding electricalpins or contacts of a connector that is configured to engage with theport 9020. The electrical contacts 9102 a-j are configured to relay thedrive signals generated by the energy module 3004 and/or support sensingand communications between the surgical instrument and the energy module3004. In one aspect, the port 9020 can include an electrical contactthat is dedicated to each of the energy modalities that the port 9020 isconfigured to deliver to a surgical instrument connected thereto. Forexample, a first contact 9102 a can be configured to deliver anultrasonic drive signal, a second contact 9102 c can be configured todeliver a bipolar electrosurgical drive signal, and a third contact 9102j can be configured to deliver a monopolar electrosurgical drive signalto a connected surgical instrument. In various aspects, the firstcontact 9102 a, second contact 9102 c, and third contact 9102 j can bearranged to prevent electrical interference between the contacts 9102 a,9102 c, 9102 j. In one aspect, the third contact 9102 j can be offset orspaced away from the first and second contacts 9102 a, 9102 c by adistance sufficient to prevent electrical arcing and shorting that couldbe caused by the high-voltage, high-crest factor monopolar drive signal.For example, the third contact 9102 j can be positioned a distance d₁from the first contact 9102 a and a distance d₂ from the second contact9102 c. The distances d₁ and d₂ can be selected to be at least theminimum necessary distances required to prevent electrical arcing andshorting between the contacts 9102 a, 9102 c, 9102 j and/or comply withrelevant safety/technical standards, such as IEC 60601.

Surgical Instrument Circuitry

Some electrosurgical instruments may require a large amount of directcurrent (DC) power for powering particular components or performingparticular functions. For example, a surgical instrument may include oneor more motors to control articulation, clamp force, blade firing, andother parameters of the instrument. As another example, a surgicalinstrument may include a high-power light-emitting diode (LED) used toilluminate the body cavity. However, some interfaces between a surgicalgenerator (e.g., an energy module) and the electrosurgical and/orultrasonic instruments may not support this type of high-power DCoutput.

In various aspects, the present disclosure provides an electrical energysource configured to deliver energy in two patient domains through thesame connector to avoid one powered “hot” device out of two coupled tothe same connector. For example, this situation may arise if a deviceincludes two end-effectors extending from a single connector. In thisenvironment, the present disclosure provides isolation techniques thatcan be employed to deliver a flexible auxiliary power supply for anenergy device. The present disclosure further provides various circuitsconfigured to enable delivery of energy from the same port in twopatient domains, and to deactivate one of two devices from that port.

In one general aspect, the present disclosure provides a surgicalgenerator (e.g., an energy module) connectable to a surgical instrument.The surgical instrument comprises an end effector to deliver energy to atissue, the surgical energy module comprising a first high poweramplifier, a second high power amplifier, and a control circuit coupledto the first high power amplifier and the second high power amplifier.The control circuit configured to cause the first high power amplifierto power the end effector to deliver energy to the tissue and cause thesecond high power amplifier to power a secondary function of thesurgical instrument.

In another general aspect, the present disclosure provides a surgicalenergy module connectable to a surgical instrument. The surgical energymodule comprises a first circuit configured to provide ultrasonic energyto the surgical instrument, a second circuit configured to providebipolar electrosurgical energy to the surgical instrument, and a thirdcircuit configured to provide monopolar electrosurgical energy to thesurgical instrument. The first circuit, the second circuit, and thethird circuit are electrically isolated from each other.

FIG. 43 is a block diagram of a surgical system 11000 including asurgical instrument 11002 connected to an energy module 11004, such asthe various energy modules described in connection with FIGS. 24-37 ,via a cable assembly 11006. As described above in fuller detail withrespect to FIGS. 31-37 , the energy module 11004 can be configured toprovide multiple different energy modality output or drive signals to asurgical instrument 11002 via a single receptacle 11005, such as theadvanced energy receptacle 3100 illustrated in FIGS. 34 and 35 . Inparticular, the energy module 11004 can include various amplifiers11014, 11016 and associated circuit components for generating drivesignals to drive an energy modality deliverable by a connected surgicalinstrument 11002 for cutting, coagulating, or otherwise therapeuticallytreating tissue. The generated drive signals can have differentfrequency ranges according to the energy modality type that the drivesignal drives. In one implementation of the energy module 11004, thefirst amplifier 11014 can include an ultrasonic amplifier and the secondamplifier 11016 can include a bipolar or monopolar electrosurgicalamplifier. Accordingly, the first amplifier 11014 can be configured togenerate an AC drive signal configured to actuate an ultrasonictransducer for driving an ultrasonic blade of the surgical instrument11002, as described in connection with FIGS. 17 and 18 . Accordingly,the second amplifier 11016 can be configured to generate an AC drivesignal configured to cause electrodes of the surgical instrument 11002to deliver electrosurgical RF current to captured tissue, as describedin connection with FIG. 19 . Additional detail regarding energymodule/generator circuit configurations for delivering variouscombinations of energy modalities can be found in herein.

Although various energy modules 11004 described herein can includemultiple amplifier types for driving different energy modalities, notall surgical instruments 11002 connectable to the energy modules 11004may require the use of the available energy modalities for treatingtissue. Accordingly, one or more of the amplifiers may be unused forparticular types of surgical instruments 11002. For example, when abipolar electrosurgical instrument is connected to the energy module11004, the bipolar amplifier (e.g., the second amplifier 11016) may beutilized for tissue treatment, but the ultrasonic amplifier (e.g., thefirst amplifier 11014) may be unused for tissue treatment. Such energymodules 11004 present a unique advantage in such situations where thesurgical instrument 11002 connected to the energy module 11004 does notrequire the use of each of the amplifiers at any given time during asurgical procedure. Namely, the one or more amplifiers that are notpresently in use for therapeutically treating tissue can be utilized bythe surgical instrument 11002 as secondary power sources for poweringother components and/or functions of the surgical instrument 11002.

In one aspect, a surgical instrument 11002 can be configured to utilizedrive signals provided from the energy module 11004 to alternativelydrive or power non-therapeutic energy application functions orcomponents of the surgical instrument 11002. For example, the surgicalinstrument 11002 may be configured to utilize an energy modality that isdriven by the second amplifier 11016 (e.g., RF electrosurgical energy)but not an energy modality that is driven by the first amplifier 11014(e.g., ultrasonic energy). In one aspect, the surgical instrument 11002can include circuitry configured to utilize the amplifier(s) drivingenergy modalities that the surgical instrument 11002 is not configuredto deliver as a DC power source. In the illustrated aspect, the surgicalinstrument 11002 includes a rectifier 11008 (e.g., a full-waverectifier) that is configured to convert the AC drive generated by thefirst amplifier 11014 into an output DC voltage. The surgical instrument11002 can include various additional hardware and/or software (e.g., afilter or a voltage regulator) for processing or smoothing the output ofthe rectifier 11008. The output DC voltage can then be utilized to powervarious components or functions of the surgical instrument 11002, suchas a light source 11010 (e.g., an LED). The light source 11010 can bepositioned on the surgical instrument 11002 for illuminating the bodycavity of the patent on which the surgical procedure is being performed,for example. In various aspects, the converted drive signal can beutilized to provide auxiliary power to the surgical instrument 11002 fora variety of different applications, including nerve stimulation (e.g.,powering a waveform generator configured to generate signals of apredetermined frequency for stimulating nerves), poweringelectromechanical components of the surgical instrument 11002 (e.g., amotor) or other loads associated with the surgical instrument 11002(e.g., a light source 11010), powering a processor or control circuitimplementing various control algorithms, powering sensors for detectingvarious parameters (e.g., tissue impedance, temperature, 3Dacceleration, clamp arm gap, clamp force, tissue type identification, orcritical structure identification), and/or charging a battery of thesurgical instrument 11002. In such aspects, the components and/orfunctions powered by the output DC voltage may be controlledsimultaneously with energy delivery by the surgical instrument 11002driven by the other drive signals generated by the energy module 11004(e.g., controlling the clamp arm force or controlling the tissue gap asthe tissue is therapeutically treated). The remaining amplifiers of theenergy module 11004 to which the surgical instrument 11002 iselectrically coupled through the connection to the receptacle 11005,such as the second amplifier 11016 in the particular implementation inFIG. 43 , can be utilized as normal to deliver the driven energymodality through the end effector 11012 to therapeutically treat tissueof the patient 11100 during a surgical procedure.

In an alternative aspect, the cable assembly 11006, rather than thesurgical instrument 11002, can include circuitry disposed therein thatis configured to convert drive signals provided from the energy module11004 to an alternative form suitable for driving or poweringnon-therapeutic energy application functions or components of thesurgical instrument 11002. For example, the cable assembly 11006 caninclude a rectifier 11008 that is configured to convert the AC drivegenerated by the first amplifier 11014 into an output DC voltage.Accordingly, the cable assembly 11006 can receive drive signalsgenerated by the energy module 11004 through its connection to thereceptacle 11005, convert one or more of the drive signals into anoutput DC voltage, and then provide the output DC voltage to thesurgical instrument 11002 to which it is connected for variousapplications, which are described above.

Although FIG. 43 depicts the surgical instrument 11002 as including asingle rectifier 11008, the surgical instrument 11002 and/or cableassembly 11006 can, in one aspect, include multiple rectifiers forconverting multiple different drive signals generated by the energymodule 11004 into DC output voltages. These DC outputs voltages canpower the same or different components and/or functions of the surgicalinstrument 11002. Further, the multiple rectifiers can be configured toconvert the same or different drive signals generated by the energymodule 11004. For example, the surgical instrument 11002 and/or cableassembly 11006 can include a first rectifier configured to convert afirst drive signal generated by the first amplifier 11014 to a firstoutput DC voltage and a second rectifier configured to convert a seconddrive signal generated by the second amplifier 11016 to a second outputDC voltage. The surgical instrument 11002 can be configured to utilizethe first and second output DC voltages to power the same or differentcomponents of the surgical instrument 11002.

In some aspects, the surgical instrument 11002 may be configured toutilize only one or less than all of the energy modalities that theenergy module 11004 is configured to drive through the receptacle 11005.For example, the surgical instrument 11002 illustrated in FIG. 38 mayonly be configured to utilize the energy modality driven by the drivesignal from the second amplifier 11016, despite the fact that the energymodule 11004 is also capable of driving a second energy modality via thedrive signal from the first amplifier 11014. In one particularimplementation, the surgical instrument 11002 may be configured to onlydeliver bipolar electrosurgical energy driven by the second amplifier11016, despite the fact that the energy module 11004 is also configuredto deliver ultrasonic energy by the first amplifier 11014 through thereceptacle 11005, for example. In such aspects, the surgical instrument11002 and/or cable assembly 11006 can be configured to automatically orinherently convert the unused drive signal(s) to DC output voltage(s).In other aspects, the surgical instrument 11002 and/or cable assembly11006 can further be configured to selectively convert the drivesignal(s) generated from one or multiple amplifiers 11014, 11016 of theenergy module 11004 based upon whether the surgical instrument 11002 isactively applying the particular energy modalities. For example, thesurgical instrument 11002 can include a control circuit, such as amicrocontroller 461 (FIG. 12 ), that is configured to determine whetheran energy modality driven by one of the amplifiers 11014, 11016 of theenergy module 11004 is actively being utilized or delivered by thesurgical instrument 11002 (e.g., being applied through the end effector11012 to therapeutically treat tissue of the patient 11100). If theenergy modality is not actively being utilized by the surgicalinstrument 11002, the control circuit can be configured to reroute thedrive signal received from the particular amplifier (e.g., the firstamplifier 11014) to a rectifier (e.g., the rectifier 11008) to convertthe drive signal to a DC output voltage for powering an alternativecomponent and/or function of the surgical instrument 11002. The controlcircuit can be further configured to reverse the rerouting of the drivesignal through the rectifier and, once again, drive the energy modalityin response to sensed conditions and/or controls by the user or anexternal system. In this way, the surgical instrument 11002 can beconfigured to dynamically reroute unused energy supplied by the energymodule 11004 depending on which particular energy modalities are in useat any given time.

Energy Module Electrical Grounding

In various aspects, an end user is permitted to assemble any suitablenumber of modules into a variety of different stacked configurationsthat support electrical energy flow therebetween. The modular energysystem is assembled or is modified by an end user either prior to orduring a surgical procedure. Since the manufacturer is not involved withthe final assembly of a modular energy system, suitable precautions aretaken to ensure proper electrical grounding of an assembled modularenergy system and/or alignment of modules within the modular energysystem.

In various aspects, accessible metal in the modular energy system iseither protectively earthed or separated from live circuits to ensureuser safety. This requirement is especially necessary in instances wheresecondary circuits are referenced to module chassis ground. Further, theprotective earth connections between the modules of a modular energysystem must meet the stringent International Electrotechnical Commission(“IEC”) 60601 maximum impedance requirements.

In one general aspect, the present disclosure provides a groundingarrangement for a modular energy system comprising an independent bridgeconnector between the modules of the modular energy system and groundsthat come into contact with each other prior to the bridge connection.

In another general aspect, the present disclosure provides a surgicalsystem that comprises a first surgical module and a second surgicalmodule. The first surgical module comprises a first enclosure comprisinga bottom surface, a grounding foot extending from the bottom surface afirst distance, and an insulating foot extending from the bottom surfacea second distance, wherein the second distance is greater than the firstdistance. The second surgical module comprises a second enclosurecomprising a top surface, a first receiving pocket defined in the topsurface, wherein the first receiving pocket comprises a first base thatis positioned a third distance from the top surface, and wherein thefirst receiving pocket is configured to receive the grounding foot fromthe first surgical module, and a second receiving pocket defined in thetop surface, wherein the second receiving pocket comprises a second basethat is positioned a fourth distance from the top surface, wherein thefourth distance is greater than the third distance, and wherein thesecond receiving pocket is configured to receive the insulating footfrom the first surgical module. Further, when the grounding foot ispositioned in the first receiving pocket and the insulating foot ispositioned in the second receiving pocket, the grounding foot contactsthe first base of the first receiving pocket and the insulating footdoes not contact the second base of the second receiving pocket.

In another general aspect, the present disclosure provides a surgicalsystem that comprises a first surgical module and a second surgicalmodule. The first surgical module comprises a first enclosure comprisinga bottom surface, a grounding foot extending from the bottom surface afirst distance, and an insulating foot extending from the bottom surfacea second distance, wherein the second distance is greater than the firstdistance. The second surgical module comprises a second enclosurecomprising a top surface, a first receiving pocket defined in the topsurface, wherein the first receiving pocket comprises a first base thatis positioned a third distance from the top surface, and wherein thefirst receiving pocket is configured to receive the grounding foot fromthe first surgical module, and a second receiving pocket defined in thetop surface, wherein the second receiving pocket comprises a second basethat is positioned a fourth distance from the top surface, wherein thefourth distance is greater than the third distance, and wherein thesecond receiving pocket is configured to receive the insulating footfrom the first surgical module. Further, when the grounding foot ispositioned in the first receiving pocket and the insulating foot ispositioned in the second receiving pocket, the grounding foot contactsthe first base of the first receiving pocket and the insulating footdoes not contact the second base of the second receiving pocket.

In another general aspect, the present disclosure provides a surgicalplatform that comprises a first surgical module and a second surgicalmodule. The first surgical module is configured to be assembled in astack configuration with the second surgical module. The first surgicalmodule comprises a first bridge connector portion comprising firstelectrical connection elements and a first enclosure. The secondsurgical module comprises a second bridge connector portion and a metalcontact attached to the outer housing. The second bridge connectorportion comprises second electrical elements and an outer housingextending at least partially around the second electrical elements. Themetal contact is configured to engage the enclosure of the firstsurgical module during assembly before the second electrical connectionelements of the second bridge connector portion engage the firstelectrical connection elements of the first bridge connector portion.

Referring to FIG. 44 , three surgical modules, a first module 9502, asecond module 9504, and a third module 9506, are assembled together in astacked configuration by an end user to form a modular energy system9500. Each module 9502, 9504, 9506, can be the same type of surgicalmodule or different types of surgical modules. For example, each module9502, 9504, 9506 can be a header module, an energy module, a generatormodule, an imaging module, a smoke evacuation module, asuction/irrigation module, a communication module, a processor module, astorage array, a surgical device coupled to a display, a non-contactsensor module, or other modular device. These and other such modules aredescribed above under the headings SURGICAL HUBS and MODULAR ENERGYSYSTEM. As illustrated in FIG. 44 , the first module 9502 is a headermodule, the second module 9504 is a generator module, and the thirdmodule 9506 is a generator module.

Each module 9502, 9504, 9506 can comprise an enclosure that can be madeof a conductive material, such as metal. For example, the first module9502 can comprise an enclosure 9508 comprising a top surface 9508 a anda bottom surface 9508 b. The second module 9504 can comprise anenclosure 9510 comprising a top surface 9510 a and a bottom surface 9510b. The third module 9506 can comprise an enclosure 9512 comprising a topsurface 9512 a and a bottom surface 9512 b. Each module 9502, 9504,9506, can comprise secondary circuits that are referenced to modulechassis ground via the respective enclosure 9508, 9510, 9512.

Each module 9502, 9504, 9506 can be configured to be assembled in astacked configuration with an adjacent module to form the modular energysystem 9500. For example, the bottom surface 9508 b of the enclosure9508 of the first module 9502 can be configured to engage the topsurface 9510 a of the enclosure 9510 of the second module 9504. Thebottom surface 9510 b of the enclosure 9510 of the second module 9504can be configured to engage the top surface 9512 a of the enclosure 9512of the third module 9506. In various aspects, the modular energy system9500 includes an additional surgical module or surgical modules or themodular energy system 9500 may not include one of the modules 9502,9504, 9506.

In various aspects, to electrically ground a modular energy system, suchas modular energy system 9500, multiple points of contact areestablished between adjacent modules to achieve a common ground. Thus,regardless of the stacked configuration of the modular energy system9500, electrical grounding can be maintained throughout the entiremodular energy system 9500. For example, an upper module stacked on topof a lower module can be grounded through the lower module in order toachieve the common ground or a lower module can be grounded through theupper module. For example, the first module 9502 can be grounded throughthe second module 9504 and the second module 9504 can be groundedthrough the third module 9506; thereby, a common ground is achieved inthe modular energy system 9500. Thus, grounding of one of the modules9502, 9504, 9506 can ground all of the modules 9502, 9504, 9506.Additionally, the multiple points of contact can facilitate efficientassembly of the stacked configuration of the modular energy system 9500and the multiple points of contact can ensure that the modular energysystem 9500 will maintain its configuration when experiencing externalforces.

Referring now to FIG. 45A, a bottom surface 9516 b of an enclosure 9516of a surgical module 9514 enclosure is shown. Module 9514 isrepresentative of modules 9502, 9504, and 9506. The bottom surface 9516b of the enclosure 9516 can include one or more grounding features, suchas, for example, two or more grounding features, three or more groundfeatures, or four or more ground features. For example, as illustrated,the bottom surface 9516 b can comprise four grounding features 9518 a-dsized and spaced apart, such that the grounding features 9518 a-d mayengage grounding features of a separate module, thus providing directcontact between the modules at multiple points. The contact can ensurethat a common ground is achieved between modules and that the module9514 can maintain its position relative to a mating module whenexperiencing external forces.

The bottom surface 9516 b of the enclosure 9516 comprises an opening9542 that is shaped and configured to mount a bridge connector portion9520 (e.g., a female bridge connector portion). The bridge connectorportion 9520 includes a recess 9538 that is shaped and configured toreceive a bridge connector portion (e.g., male bridge connector portion)from a separate module.

Referring now to FIG. 46 , a top surface 9516 a of the enclosure 9516 ofthe module 9514 is shown. The top surface 9516 a of the enclosure 9516can include one or more grounding features, such as, for example, two ormore grounding features, three or more grounding features, or four ormore grounding features. For example, as illustrated, the top surface9516 a can comprise four grounding features 9522 a-d. The groundingfeatures 9522 a-d on the top surface 9516 a are sized and spaced apartsuch that the grounding features 9522 a-d may engage grounding featuresof a separate module, thus providing direct contact between the modulesat multiple points. The contact can ensure that a common ground isachieved between the modules and that the module 9514 can maintain itsposition relative to the mating module when experiencing externalforces.

A bridge connector portion 9536 (e.g., a male bridge connector portion)is mounted to the top surface 9516 a of the enclosure 9516 of the module9514 and extends away from the module 9514. When an upper module isstacked on top of the module 9514, the bridge connector portion of themodule 9514 is inserted into the recess of a female bridge connectorportion of the upper surgical module, thereby establishing electricaland/or signal communication between the modules and/or alignment betweenthe modules. In an alternative configuration where a male bridgeconnector portion is on the bottom surface of an upper module and thefemale connector portion is on the top surface of a lower module, whenthe upper module is stacked on top of the lower module, the male bridgeconnector portion of the upper module is inserted into the recess of thefemale bridge connector portion of the lower module, therebyestablishing electrical and/or signal communication between the modulesand/or alignment between the modules.

In various aspects, the bridge connector portion 9536 can comprise agrounding feature configured to achieve a common ground between modules.For example, referring to FIG. 49 , a male bridge connector portion9570, including a grounding feature 9574 attached to an outer housing9572 of the male bridge connector portion 9570, is shown. The outerhousing 9572 extends at least partially around the electrical connectionelements 9576. The outer housing 9572 is rectangular and rounded alongthe length of the outer housing 9572. The outer housing 9572 includesrounded or curved-top faces 9578 that allow male and female bridgeconnector portions to align even when modules are at a difficult anglewith another. In other words, the outer housing 9572 is shaped and/orsized to guide the electrical connection elements 9576 and groundingfeature 9574 into a properly aligned engagement with a female bridgeconnector. The grounding feature 9574 is attached to a first side 9572 aof the outer housing 9572 and is in electrical communication with anenclosure of a respective module and/or a ground of the respectivemodule. In various aspects, another grounding feature (not shown) isattached to the second side 9572 b of the outer housing 9572 and is inelectrical communication with the enclosure of the respective moduleand/or the ground of the respective module. In various aspects, thefirst side 9572 a and the second side 9572 b are shorter than a thirdside 9572 c and a fourth side 9572 d of the outer housing 9572. Thegrounding feature 9574 can comprise a metal contact, such as, forexample, a springing contact.

When an upper module is stacked on top of a lower module comprising themale bridge connector portion 9570 on a top surface of the lower module,the male bridge connector portion 9570 is inserted into the recess of afemale bridge connector on the bottom surface of the upper surgicalmodule. Upon insertion, the grounding feature 9574 can engage theenclosure of the upper surgical module. For example, the male bridgeconnector portion 9570 can be inserted into the recess 9538 of themodule 9514 in FIG. 45A. Upon insertion, the grounding feature 9574 candirectly contact the enclosure 9516 near the opening 9542 therebyachieving a common ground between a surgical module comprising the malebridge connector portion 9570 and the module 9514.

Further, the outer housing 9572 of the male bridge connector portion9570 is shaped and/or sized to guide the grounding feature 9574 intodirect contact with the enclosure of a separate module. In aspects wherethe grounding feature 9574 is a springing contact, the springing contactis transitioned into a biased configuration responsive to direct contactwith the enclosure of the separate module. The springing contact canensure that a proper common ground is achieved between modules.

Further, the grounding feature 9574 can be configured to engage theenclosure of a separate module during assembly before the electricalconnection elements 9576 of the male bridge connector portion 9570engage electrical connection elements of a bridge connector portion onthe separate module. That is, the grounding feature 9574 can bepositioned on the outer housing 9572 relative to the electricalconnection elements 9576 such that the grounding feature 9574 willengage the enclosure of the separate module during assembly before theelectrical connection elements 9576 of the male bridge connector portion9570 engage the electrical elements of a bridge connector portion on theseparate module. Therefore, a common ground can be achieved betweenmodules prior to engagement of the bridge connector portions that canensure user safety.

In addition to the grounding feature 9574 or alternatively to thegrounding feature 9574, direct contact between the grounding features ona top surface of an enclosure of a lower module and the groundingfeatures on the bottom surface of an enclosure of an upper modulestacked on top of the lower module function to ground the upper moduleto the lower module, thereby providing multiple points of contact tomaintain a path of least resistance (e.g., electrical resistance betweenmodules). When the upper module is stacked on top of a lower module, theweight of the upper module maintains the grounding features on bottomsurface of the upper module in electrical communication with thegrounding features on the top surface of the lower module.

Furthermore, the grounding features 9518 a-d and 9522 a-d of the module9514 can be arranged in a spread configuration to maintain a path ofleast resistance between surgical modules in the stacked configuration.For example, the grounding features 9518 a-d can be spaced apart nearthe four corners of the bottom surface 9516 b of the enclosure 9516 andthe ground features 9522 a-d can be spaced apart near the four cornersof the top surface 9516 a of the enclosure 9516. That is, the bottomsurface 9516 b can comprise one of grounding features 9518 a-d at eachcorner, and the top surface 9516 a can comprise one of groundingfeatures 9522 a-d at each corner. The positions of the groundingfeatures 9518 a-d on the bottom surface 9516 b can mirror the positionsof the grounding features 9522 a-d on the top surface 9516 a, therebyproviding stability to the stacked configuration.

The grounding features 9518 a-d and 9522 a-d can be molded into theenclosure 9516, or the grounding features 9518 a-d and 9522 a-d can befastened to the enclosure. For example, the grounding features 9518 a-dand 9522 a-d can be at least one of a receiving pocket molded in theenclosure 9516, a grounding foot molded in the enclosure 9516, aconductive pin fastened to the enclosure 9516, or a conductive socketfastened to the enclosure 9516.

In various aspects, the grounding features 9518 a-d extend away from thebottom surface 9516 b of the enclosure 9516 and the module 9514 (e.g.,form grounding feet) and are sized and spaced apart such that thegrounding features 9518 a-d may be received by receiving pockets of aseparate module, thus providing direct contact between the modules infour distinct places. Further, in various aspects, the groundingfeatures 9522 a-d are configured as receiving pockets and are sized andspaced apart such that grounding feet of a separate surgical module canbe seated into the grounding features 9522 a-d, thus providing directcontact between the surgical modules in four distinct places. The directcontact can achieve a common ground, provide a path of least resistance,and maintain position of the module 9514 when experiencing externalforces.

The grounding features 9518 a-d can have various shapes, such as, forexample, circular, as illustrated in FIGS. 45A-B. A detailed view of asingle grounding feature 9518 of grounding features 9518 a-d can be seenin FIG. 45B. A base portion 9524 a of the grounding feature 9518 canhave a first diameter, ϕ₁. The grounding feature 9518 can taper inwardlyfrom the base portion 9524 a to form a seating portion 9524 b of thegrounding feature 9518. The taper can facilitate alignment of themodules during assembly. The seating portion 9524 b can have a seconddiameter, ϕ₂, which is smaller than the first diameter, ϕ₁, of the baseportion 9524 a. The seating portion 9524 b can be configured to beseated in a receiving pocket of a top surface of an enclosure of aseparate module.

Similarly, the grounding features 9522 a-d can have various shapes, suchas, for example, circular, as illustrated in FIG. 46 . The groundingfeatures 9522 a-d can each comprise a third diameter, ϕ₃, near the topsurface 9516 a, which can be sized to receive grounding feet on a bottomsurface of an enclosure of a separate module and/or engage conductiveposts on the bottom surface. For example, the third diameter, ϕ₃, of thegrounding features 9522 a-d can be larger than the second diameter, ϕ₂,of the seating portion 9524 b of the grounding features 9518 a-d. It iscontemplated that the grounding features 9518 a-d and 9522 a-d can be ofother shapes and sizes.

In aspects comprising grounding feet extending from the bottom surfaceof a module, the arrangement of the grounding features can leave thegrounding features of the lowest/bottom module in a stacked arrangementof a modular energy system without corresponding receiving pockets in aseparate module. One possible, albeit expensive, solution is toespecially design a module to function as the lowest/bottom module inthe stacked configuration of the modular energy system. However, an enduser may mistakenly attempt to assemble this especially designed modulein an intermediate position in the stacked configuration of the modularenergy system, potentially leaving the grounding features oflowest/bottom module in the stacked configuration exposed. Moreover,when a series of modules are assembled together to form the stackedconfiguration of the modular energy system, it is envisioned that thestacked modular energy system is rested upon a flat surface, such as,for example, a cart, a table, or the like. Positioning the groundingfeatures against such flat surfaces can be problematic. Further, it isdesirable that any module from the stacked modular energy system becapable of being positioned in the lowest/bottom position in the stackedconfiguration without having to worry about achieving a specificarrangement of the modular energy system. Enabling agnostic positioningof the modules can facilitate ease of assembly of the modular energysystem.

FIGS. 45A-B and 46 present a solution to the above-raised issues thataccount for when a surgical module is positioned on the lowest/bottomposition (e.g., the third module 9506 in FIG. 44 ) in the stackedconfiguration of the modular energy system 9500 and rests on a flatsurface. In various aspects, the bottom surface 9516 b of the enclosure9516 further includes an insulated foot or insulated feet. For example,referring again to FIG. 45A, the bottom surface 9516 b includes fourinsulated feet 9526 a-d extending from the bottom surface 9516 b of theenclosure 9516. The insulated feet 9526 a-d are configured toelectrically isolate the enclosure 9516 from the flat surface and/ormaintain position of the module 9514 relative to the flat surface whenexperiencing external forces. The grounding features 9518 a-d extendfrom the bottom surface 9516 b of the enclosure 9516 a first distance,d₁, and the insulated feet 9526 a-d extend from the bottom surface 9516b of the enclosure 9516 a second distance, d₂, such that when the module9514 is positioned on the lowest/bottom position in the stackedconfiguration of the modular energy system 9500, the grounding features9518 a-d do not rest on the flat surface. The insulated feet 9526 a-drest on the flat surface and can prevent the grounding features 9518 a-dfrom engaging the flat surface.

The insulated feet 9526 a-d can electrically isolate the enclosure 9516from the flat surface. For example, the insulated feet 9526 a-d cancomprise an insulating material, such as rubber. It is contemplated thatother insulating materials can be utilized to form the insulating feet9526 a-d. Additionally, the material of the insulated feet 9526 a-d canbe selected to create friction between the module 9514 and the flatsurface in order to maintain the position of the module 9514 relative tothe flat surface when experiencing external forces.

The insulated feet 9526 a-d can be spaced apart in a spreadconfiguration to provide stability to the module 9514 and/or surgicalmodules stacked on top of the module 9514. For example, the insulatedfeet 9526 a-d can be spaced apart near the four corners of the bottomsurface 9516 b of the enclosure 9516. For example, one insulated foot ofthe insulated feet 9526 a-d can be positioned in each corner of thebottom surface 9516 b. The quantity of insulated feet 9526 a-d cancorrespond to the quantity of grounding features 9518 a-d.

The insulated feet 9526 a-d can have various shapes, such as, forexample, as illustrated in FIGS. 45A-B. The insulated foot 9526 cantaper inwardly from a base portion 9580 a to form a seating portion 9580b of the insulated foot 9526. The taper can facilitate alignment of themodules during assembly. The seating portion 9580 b can be configured tobe seated in a receiving pocket of a top surface of an enclosure of aseparate module.

Each insulated foot 9526 a-d can be configured in an “L” shape. Forexample, in FIG. 45B, the “L” shaped configuration of a single insulatedfoot 9526 of the insulated feet 9526 a-d is shown. Referring to backFIG. 45A, the “L” shape configuration of the insulated feet 9526 a-d canprovide mechanical stability when the module 9514 is placed on top ofthe flat surface, ensuring that the module 9514 will maintain itsposition when experiencing external forces. It is contemplated that theinsulated feet 9526 a-d can be of other shapes and sizes.

In various aspects, the top surface 9516 a of the enclosure 9516 furtherincludes one or more receiving pockets sized and configured forreceiving an insulated foot or insulated feet of a separate surgicalmodule, such that the grounding features of the respective modules candirectly contact to achieve a common ground. For example, referringagain to FIG. 46 , the top surface 9516 a of the enclosure 9516 includesfour insulated feet receiving pockets 9528 a-d. The receiving pockets9528 a-d can be spaced apart in a spread configuration to align themodule 9514 with the separate module. For example, the receiving pockets9528 a-d are spaced apart such that the insulated feet of a separatemodule will be positioned within the receiving pockets 9528 a-d when theseparate module is stacked on top of the module 9514. As illustrated inFIG. 46 , the receiving pockets 9528 a-d are spaced apart near the fourcorners of the top surface 9516 a of the enclosure 9516. For example,one of the receiving pockets 9528 a-d is positioned in each corner ofthe top surface 9516 a of the enclosure 9516. The receiving pockets 9528a-d are sized and configured to receive insulated feet of a separatemodule.

The receiving pockets of the grounding features 9522 a-d of the topsurface 9516 a of the module can each include a base that is positioneda third distance, d₃, from the top surface 9516 a. In various aspects,the third distance, d₃, is less than or equal to the first distance, d₁,such that grounding feet of a separate module can contact the base ofthe receiving pockets of the grounding features 9522 a-d. The receivingpockets 9528 a-d each include a base that is positioned a fourthdistance, d₄, from the top surface 9516 a. In various aspects, thefourth distance, d₄, is greater than the second distance, d₂, such thatthe insulated feet of a separate module can be received by the receivingpockets 9528 a-d.

FIG. 47 illustrates a cutaway view of a portion of an upper surgicalmodule 9530 stacked on top of a lower surgical module 9532. The uppermodule 9530 and the lower module 9532 can be the same type of module ordifferent types of modules. An insulated foot 9526 representative ofinsulated feet 9526 a-d, a grounding feature 9518 representative of thegrounding features 9518 a-d, a grounding feature 9522 representative ofgrounding features 9522 a-d, and an insulated foot receiving pocket 9528representative of receiving pockets 9528 a-d are shown in FIG. 47 . Theupper module 9530 includes the grounding feature 9518 and the insulatedfoot 9526 extending from the bottom surface 9534 b of the enclosure 9534of the upper module 9530. The grounding feature 9518 extends from thebottom surface 9534 b of the enclosure 9534 of the upper module 9530 afirst distance, d₁, while the insulated foot 9526 extends from thebottom surface 9534 b of the enclosure 9534 of the upper module 9530 asecond distance, d₂. The second distance, d₂, is greater than the firstdistance, d₁. Therefore, if the upper module 9530 is set on a flatsurface, the insulated foot 9526 may contact the flat surface prior tothe grounding feature 9518 and can prevent the grounding feature 9518from contacting the flat surface.

The lower module 9532 includes the grounding feature 9522 and theinsulated foot receiving pocket 9528 on a top surface 9540 a of anenclosure 9540 of the lower module 9532. The grounding feature 9522comprises a grounding feature receiving pocket 9544 defined in the topsurface 9540 a. The receiving pocket 9544 is sized and configured toreceive the grounding feature 9518 of the upper module 9530. Thereceiving pocket 9544 includes a base 9544 a that is positioned a thirddistance, d₃, from the top surface 9540 a. In various aspects, the thirddistance, d₃, is less than or equal to the first distance, d₁.

The receiving pocket 9528 is defined in the top surface 9540 a of theenclosure 9540 of the lower module 9532. The receiving pocket 9528 issized and configured to receive the insulated foot 9526 of the uppermodule 9530. The receiving pocket 9528 includes a base 9546 a that ispositioned a fourth distance, d₄, from the top surface 9540 a. Asillustrated, the fourth distance, d₄, is greater than the seconddistance, d₂.

Owing to the size and configuration of the grounding feature 9518,insulated foot 9526, the grounding feature 9522, and the receivingpocket 9528, when the upper module 9530 is stacked on top of the lowermodule 9532, the grounding feature 9518 is seated in the receivingpocket 9544 of the ground feature 9522 such that the grounding feature9518 makes direct contact with the base 9544 a of the receiving pocket9544. While the grounding feature 9518 makes direct contact with thebase 9544 a, the insulated foot 9526 does not make contact with the base9546 a of the receiving pocket 9528 and a clearance 9548 is definedbetween the insulated foot 9526 and the base 9546 a of the receivingpocket 9528. Thus, the grounding features 9518 and 9522 are in directcontact with each other and a common ground is achieved.

In an alternative configuration, referring to FIG. 50 , a groundingfeature 9592 can extend away from a top surface 9594 a of an enclosure9594 of a module 9596 (e.g., form grounding feet). Further, in variousaspects, a grounding feature 9582 of a bottom surface 9584 a of anenclosure 9584 of a separate module 9586 can be configured as areceiving surface, which is sized such that grounding feet of a separatesurgical module can be seated onto or otherwise in contact with thegrounding features 9592, thus providing direct contact between thesurgical modules. The grounding feature 9592 can be a substantiallyplanar surface and may not protrude from the bottom surface 9584 a ofthe enclosure 9584. The module 9596 can comprise a receiving pocket 9590defined in the top surface 9594 a that is sized and configured toreceive the insulated foot 9588 of the module 9586. While the groundingfeature 9582 makes direct contact with the grounding feature 9592, theinsulated foot 9588 does not make contact with the receiving pocket 9590and a clearance 9600 is defined between the insulated foot 9588 and thereceiving pocket 9590.

Accordingly, when an upper module is stacked on top of a lower module toform a stack configuration, the grounding features of the upper moduleare in direct contact with the grounding features of the lower moduleand the insulated feet of the upper module are floating in the receivingpockets of the lower module, thereby defining a clearance therebetween.When the lower surgical module is removed from the stack configurationand the upper module is to be positioned on a flat surface, theinsulated feet of the upper module make direct contact with the flatsurface, while the grounding features of the upper module do not makecontact with the flat surface, owing to the insulated feet extending agreater distance from the bottom surface of the enclosure of the uppermodule than the grounding features.

The above described configuration allows each module to have identicalgrounding features, insulated feet, and receiving pockets, regardless ofthe position of the module within the stacked arrangement of a modularenergy system, thereby enabling efficient assembly of the modular energysystem 9500.

Referring to FIGS. 48A and 48B, an upper surgical module 9552 and alower surgical module 9554 in a stack configuration of a portion of amodular energy system 9550 are shown. The upper module 9552 and thelower module 9554 can be the same type of module or different types ofmodules.

As illustrated in FIG. 48A, two grounding features 9558 a-b of the lowermodule 9554 are shown. Each grounding feature 9558 a-b can individuallybe configured as a conductive post or a conductive socket. Asillustrated, the grounding features 9558 a-b are configured asconductive posts extending from a top surface 9560 a of an enclosure9560 of the of the lower module 9554. In various aspects, conductiveposts 9558 a-b can be integrated into the enclosure 9560 of the lowermodule 9554 or the conductive posts 9558 a-b can be fastened to theenclosure 9560 of the lower module 9554. For example, the conductiveposts 9558 a-b can be fastened to the enclosure 9560 of the lower module9554 with nuts and/or with or without lock washers.

Two grounding features 9562 a-b of the upper module 9552 are shown. Eachgrounding feature 9562 a-b can be individually configured as aconductive post or a conductive socket. As illustrated, the groundingfeatures 9562 a-b are configured as conductive sockets defined in abottom surface 9564 b of an enclosure 9564 of the upper module 9552.When the upper and lower modules 9552, 9554 are in a stackedconfiguration, the conductive posts 9558 a-b of the lower module 9554can be retained in the corresponding conductive socket 9562 a-b of theupper module 9552.

The post/socket configuration of the modules 9552, 9554 can improvealignment between the modules. For example, the grounding features 9558a-b can be sized and configured to engage the grounding features 9562a-b prior to engagement of a bottom bridge connector portion (not shown)of the upper module 9552 (e.g., bridge connector portion 9520 in FIG.45A) and a top bridge connector portion (not shown) of the lower module9554 (e.g., bridge connector portion 9536 in FIG. 46 ) such that properalignment of the bridge connector portions is achieved during assemblyof the modules 9552, 9554 into a stacked configuration. In variousaspects, it may desirable to achieve a common ground between adjacentmodules prior to engagement of the respective bridge connector portionsof the adjacent modules to ensure user safety. Thus, the groundingfeatures 9558 a-b and 9562 a-b can be configured to engage each otherprior to the respective bridge connector portions.

In various aspects, as illustrated in FIG. 48A, the post/socketconfiguration can be implemented with rigid conductive posts 9558 a-b onthe lower module 9554 and springing conductive sockets 9562 a-b on theupper module 9552 that are transitioned into a biased configuration uponreceiving their corresponding posts 9588-b. Alternatively, asillustrated in FIG. 48B, the post/socket configuration can beimplemented with a springing post 9566 on the lower module 9554 and arigid socket 9568 on the upper module 9552. The springing sockets and/orspringing posts can ensure that a proper common ground is achievedbetween the surgical modules 9552, 9554. A springing post can be aspring-loaded connector and a springing socket can be a spring-loadedsocket connector.

Energy Module Bridge Connector

In various aspects, an end user is permitted to assemble any suitablenumber of modules into a variety of different stacked configurationsthat support electrical energy flow therebetween. Each of the differenttypes of modules provides different functionality, thereby allowingindividuals to customize the functions provided by each surgicalplatform by customizing the modules that are included in each surgicalplatform. The modular energy system is assembled or is modified by anend user either prior to or during a surgical procedure. Since themanufacturer is not involved with the final assembly of a modular energysystem, suitable precautions are taken to ensure proper stacking of anassembled modular energy system and/or alignment of modules within themodular energy system.

As discussed above, the one or more modules can be connected together ina variety of different stacked configurations to form various modularenergy systems. When positioned in the variety of different stackedconfigurations, the surgical modules are configured to communicate andtransmit power therebetween. It is contemplated that external wiringconnections can be utilized in order to electrically couple the moduleswhen stacked together to facilitate the transmission of communicationsignals and power. However, it is desirable that the modules beconnectable together without the need for external wiring to facilitatesafe assembly and disassembly by an end user. To that end, the modulescan include bridge connectors that are configured to transmit powerand/or communication signals between the modules in the modular energysystem when the modules are assembled or engaged together.

In one general aspect, the present disclosure provides a connectorpositioned on the top and a socket on the bottom of a stackable energymodule, which can carry communication and power through multiple units(i.e., modules). The connector shape facilitates mechanical alignment,then grounding, then electrical contact of a series of power andcommunication lines when multiple energy modules are assembled togetherinto a modular energy system.

In another general aspect, the present disclosure provides a bridgecircuit that is segmented into identical boards residing within eachmodule and is connected by connectors shaped to align and connect avariable number of stacked modules together (including a header module).

In another general aspect, the present disclosure provides a moduleconnector configured to have a first or stowed configuration and secondor extended configuration. The modular connectors for energy modules(and/or other modules of a modular energy system) can carry bothcommunication and power between modules, where the connector isconfigured to be transitioned between the stowed configuration, whichhas a first low profile, and the extended configuration, which providesfor both an electrical and mechanical connection between modules.

In yet another general aspect, the present disclosure provides asurgical platform comprising a first surgical module and a secondsurgical module. The first surgical module is configured to be assembledin a stack configuration with the second surgical module. The firstsurgical module includes a first bridge connector portion, whichcomprises a first outer housing and first electrical connectionelements. The second surgical module comprises a second bridge connectorportion, which comprises a second outer housing and second electricalconnection elements. The second outer housing is shaped and configuredto engage the first outer housing during the assembly before secondelectrical connection elements engage the first electrical connectionelements.

In yet another general aspect, the present disclosure provides asurgical platform comprising a first surgical module and a secondsurgical module. The first surgical module comprises a first enclosurecomprising a bottom surface, a first bridge connector, wherein the firstbridge connector comprises a recess, a first printed circuit board(PCB), and a first wire assembly connected to the first PCB. The firstwire assembly extends from the first PCB to the first bridge connectorand the first wire assembly is operably coupled to the first bridgeconnector. The second surgical module comprises a second enclosurecomprising a top surface, a second bridge connector, a second PCB, and asecond wire assembly connected to the second PCB. The second bridgeconnector extends away from the top surface and the second bridgeconnector is configured to be positioned in the recess of the firstbridge connector of the first surgical module. The second wire assemblyextends from the second PCB to the second bridge connector and thesecond wire assembly is operably coupled to the second bridge connector.When the second bridge connector is positioned in the first bridgeconnector, the second wire assembly is electrically coupled with thefirst wire assembly.

Referring now to FIGS. 51 and 52 , a configuration is shown in whichthree surgical modules, a first module 10002, a second module 10004, anda third module 10006, are assembled together in a stacked configurationby an end user utilizing an internal wiring arrangement to facilitatethe transmission of communication signals and power between modules in amodular energy system 10000. Each module 10002, 10004, and 10006, can bethe same type of surgical module or different types of surgical modules.For example, each module 10002, 10004, and 10006, can be a headermodule, an energy module, a generator module, an imaging module, a smokeevacuation module, a suction/irrigation module, a communication module,a processor module, a storage array, a surgical device coupled to adisplay, a non-contact sensor module, or other modular device. These andother such modules are described above under the headings SURGICAL HUBSand MODULAR ENERGY SYSTEM.

Each module 10002, 10004, and 10006, can include a bridge connector. Forexample, the first module 10002 can comprise a lower bridge connector10008, the second module 10004 can comprise an upper bridge connector10010 (FIG. 53 ) and a lower bridge connector 10012, and the thirdmodule 10006 can comprise an upper bridge connector (not shown) and alower bridge connector 10016. Each bridge connector, 10008, 10010,10012, and 10016, can include an outer housing extending at leastpartially around electrical connection elements of the respective bridgeconnector.

Referring to FIG. 53 , a detailed view of an embodiment of the secondmodule 10004 is provided. It is understood the first module 10002 andthe third module 10006 can be configured as the second module 10004illustrated in FIG. 53 . The upper bridge connector 10010 of the secondmodule 10004 is mounted to a top surface 10018 a of the enclosure 10018and extends away from the second module 10004. The lower bridgeconnector 10012 of the second module 10004 is mounted to the bottomsurface 10018 b of the enclosure 10018 of the second module 10004. Thelower bridge connector 10012 includes a recess 10020 that is shaped andconfigured to receive an upper bridge connector from a separate module.For example, when the second module 10004 is stacked on top of the thirdmodule 10006, the upper bridge connector of the third module 10006 isinserted into the recess 10020 of the lower bridge connector 10016 ofthe second module 10004, thus, aligning the second module 10004 with thethird module 10006.

Referring to back to FIGS. 51 and 52 , each module, 10002, 10004, and10006, further includes a PCB. For example, the first module 10002includes a first PCB 10022, the second module 10004 includes a secondPCB 10024, and the third module 10006 includes a third PCB 10026.

Additionally, each module, 10002, 10004, and 10006, includes a flexiblewire harness (e.g., flexible cable) electrically connected to therespective PCB, 10022, 10024, and 10026, by any suitable number ofconnections. For example, the first module 10002 includes a firstflexible wire harness 10028 extending from the first PCB 10022 andoperably coupled to the lower bridge connector 10008 of the first module10002 to connect the first PCB 10022 with electrical connection elementsof the lower bridge connector 10008. The first flexible wire harness10028 is positioned within the first module 10002 and, thus, mayfacilitate quicker assembly of a modular energy system.

The second module 10004 includes a second flexible wire harness 10030and a third flexible wire harness 10032 extending from the second PCB10024. The second flexible wire harness 10030 is operably coupled to theupper bridge connector 10010 of the second module 10004 to connect thesecond PCB 10024 with electrical connection elements of the upper bridgeconnector 10010. The third flexible wire harness 10032 is operablycoupled to the lower bridge connector 10012 of the second module 10004to connect the second PCB 10024 with electrical connection elements ofthe lower bridge connector 10012. The second and third flexible wireharnesses 10030 and 10032 are positioned within the second module 10002and, thus, may facilitate quick assembly of a modular energy system.

The third module 10006 includes a fourth flexible wire harness 10034 anda fifth flexible wire harness 10036 extending from the third PCB 10026.The fourth flexible wire harness 10034 is operably coupled to the upperbridge connector of the third module 10006 to connect the third PCB10026 with electrical connection elements of the upper bridge connectorof the third module 10006. The fifth flexible wire harness 10036 isoperably coupled to the lower bridge connector 10016 of the third module10006 to connect the third PCB 10026 with the electrical connectionelements of the lower bridge connector 10016. The fourth and fifthflexible wire harnesses 10034 and 10036 are positioned within the thirdmodule 10002 and thus, may facilitate quick assembly of a modular energysystem.

When an upper bridge connector of a lower module is positioned in alower bridge connector of an upper module (e.g., the electricalconnection elements of the bridge connectors are electrically coupled),the upper flexible wire harness connected to the upper bridge connectorof the lower module is electrically coupled with the lower flexible wireharness connected to the lower bridge connector of the upper module.When coupled, power and communication signals are able to flow from thelower module to the upper module (and/or from the upper module to thelower module) by way of the internal flexible wire harnesses and thePCBs. For example, when the upper bridge connector 10014 of the thirdmodule 10006 is positioned in the lower bridge connector 10012 of thesecond module 10004, the fourth flexible wire harness 10034 iselectrically coupled with the third flexible wire harness 10032. Thus,power and communications signals are able to flow from the third module10006 to the second module 10004 by way of the third and fourth flexiblewire harnesses, 10032 and 10034, and the respective PCBs, 10023 and10026.

Referring back to FIGS. 51-53 , in one instance, a board connector 10038is mounted on the second PCB 10024 and a board connector 10066 ismounted on the third PCB 10026. The second flexible wire harness 10030is configured to extend from the upper bridge connector 10010 andconnect to the board connector 10038, while the third flexible wireharness 10032 is configured to extend from the lower bridge connector10012 and connect to the board connector 10038. The fourth flexible wireharness 10034 is configured to extend from the upper bridge connector ofthe third module 10006 and connect to the board connector 10066, whilethe fifth flexible wire harness 10036 is configured to extend from thelower bridge connector 10016 and connect to the board connector 10066.

Similar to the scenario described above, when an upper module isconnected with a lower module by way of respective bridge connectors,the upper and lower modules are able to communicate and transmit powertherebetween by way of the PCBs, the board connectors, and the flexiblewire harnesses. For example, referring to FIG. 52 , power andcommunications signals are able to flow from the third module 10006 tothe second module 10004 by way of the third and fourth flexible wireharnesses, 10032 and 10034, the board connectors, 10038 and 10066, andthe respective PCBs, 10024 and 10026.

Referring now to FIG. 54 , a separate embodiment of a module 10040 isshown. The module 10040 illustrated in FIG. 54 is similar in manyrespects to the second module 10004 shown and described in FIGS. 51-53 .However, instead of a flexible wire harness, a rigid wire harness 10042is utilized. The rigid wire harness 10042 can be sized and configured tostand between a top surface 10044 a of an enclosure 10044 of the module10040 and a bottom surface 10044 b of the enclosure 10044 of the module10040. The rigid wire harness 10042 can extend the full, or at leastsubstantially the full, height, h₁, of the module 10040. Further, theupper and lower bridge connectors, 10046 and 10048, are operably coupled(e.g., directly mated) to the rigid wire harness 10042 rather than tothe enclosure 10044 of the module 10040. In at least one example, theupper and lower bridge connectors, 10046 and 10048, are integrated withthe rigid wire harness 10042.

In the example of FIG. 54 , upper wires 10050 extend from a boardconnector 10054 on the PCB 10056, along the rigid wire harness 10042,and connect to the upper bridge connector 10046. In addition, lowerwires 10052 extend from the board connector 10054 and connect to thelower bridge connector 10048. The lower bridge connector 10048 includesa recess 10062 that is shaped and configured to receive an upper bridgeconnector from a separate module.

A series of holding members 10058 can extend from the rigid wire harness10042, which are configured to wrap, or at least partially wrap, aroundthe upper wires 10050 to support the upper wires 10050 within apredetermined distance from the rigid wire harness 10042. In the exampleof FIG. 54 , the holding members 10058 extend from a backbone column10060 that supports the upper and lower bridge connectors, 10046 and10048.

The ability to mate the rigid wire harness 10042 with the upper bridgeconnector 10046 and lower bridge connector 10048 provides a distinctadvantage when assembling the module 10040. As the rigid wire harness10042 is one piece and extends the full, or at least substantially thefull, height, h₁, of the module 10040, the rigid wire harness 10042 canbe inserted into the module 10040 during assembly of the module 10040and stand free. Once assembled into the module 10040, the upper andlower bridge connecters, 10046, 10048, can be mated directly with therigid wire harness 10042, thereby eliminating the need to mount theupper and lower bridge connectors, 10046, 10048, to the top and bottomsurfaces, 10044 a, 10044 b, of the enclosure 10044, respectively, thus,reducing assembly time. The rigid wire harness 10042 can limit forceapplied to an enclosure 10044 of the module 10040 during assembly of amodular energy system and can reliably establish and/or maintainconnections between bridge connectors.

Referring to FIG. 70 , in a separate embodiment, the flexible wirehardness or rigid wire harness can be replaced by a rigid connector10252 as shown. The rigid connector 10252 can comprise an integratedupper bridge connector 10254, an integrated lower bridge connector10256, a PCB extending between the bridge connectors, 10254 and 10256,and a PCB connector 10260. The PCB of the rigid connector 10252 canestablish electrical and/or signal communication between the upperbridge connector 10254, the lower bridge connector 10256, and/or the PCBconnector 10260. The PCB connector 10260 can be connected to a PCB of amodule to establish electrical and/or signal communication between therigid connector 10252 and the PCB of the module. Further, the rigidconnector 10252 can comprise an outer housing 10258 that is over-moldedaround the PCB of the rigid connector 10252 and can be configured tomate to the enclosure of a module.

The rigid connector 10252 can be sized and configured to stand between atop surface of an enclosure of a module and a bottom surface of theenclosure of the module. The PCB connector 10252 can extend the full, orat least substantially the full, height of the module.

Referring to FIGS. 71-72 , a separate embodiment of a rigid connector10262 is provided. The rigid connector 10262 can comprise an integratedupper bridge connector 10264, an integrated lower bridge connector10256, a PCB 10268 extending between the bridge connectors, 10264 and10266, and a PCB connector 10270. The PCB 10268 can establish electricaland/or signal communication between the upper bridge connector 10264,the lower bridge connector 10266, and/or the PCB connector 10270. ThePCB connector 10270 can be connected to a PCB of a module to establishelectrical and/or signal communication between the rigid connector 10262and the PCB of the module.

The rigid connector 10262 can be sized and configured to stand between atop surface of an enclosure of a module and a bottom surface of theenclosure of the module. The rigid connector 10262 can extend the full,or at least substantially the full, height of the module. The rigidconnector 10252 in FIG. 70 and/or the rigid connector 10262 in FIGS.71-72 can reduce assembly time.

In various aspects, as noted above, the modules of a modular energysystem are connected via bridge connectors. Due to the weight of themodules, a user may find it difficult to align bridge connectors duringstacking of the modules or assembly of the modular energy system. Incertain instances, the user may damage the electrical connectionelements of the bridge connectors during stacking. The bridgeconnectors, 10070 and 10074, illustrated in FIGS. 55-57 allow formodules to be stacked and connected together while being insensitive tothe angle that male and female portions of the connectors initiallymate. The bridge connector 10070 can be operably coupled to the modulesas described herein. For example, the bridge connector 10070 can be theupper bridge connector on any one or more of the modules 10002, 10004,10006, and 10040 in FIGS. 51-53 , and the bridge connector 10074 can bethe lower bridge connector on any one or more of the modules 10002,10004, 10006, and 10040 in FIGS. 51-53 .

As illustrated in FIGS. 55-56 , the bridge connector 10070 includes anouter housing 10072 that extends at least partially around theelectrical connection elements 10076 (e.g., pins). For example, theelectrical connection elements 10076 can be recessed within the outerhousing 10072. The outer housing 10072 is shaped and configured toengage an outer housing of a separate bridge connector during assemblyof a stacked configuration of a modular energy system before theelectrical connection elements 10076 engage the electrical connectionelements of the separate bridge connector.

As illustrated in FIGS. 55-56 , the bridge connector 10070 is a malebridge connector. The bridge connector 10070 and a female bridgeconnector are shaped and configured to cooperate to properly align theelectrical connection elements of the female bridge connector with theelectrical connection elements 10076 during assembly of a stackedconfiguration of a modular energy system. For example, an assembledconfiguration of the bridge connector 10070 with a female bridgeconnector 10074 is illustrated in FIG. 57 .

The outer housing 10072 is rectangular and rounded along the length ofthe outer housing 10072. In various aspects, the bridge connector 10070protrudes from a top surface of a first module and a female bridgeconnector 10074 is recessed into a bottom surface of a separate module.The outer housing 10072 includes rounded or curved top faces 10078 thatallow male and female bridge connectors to align even when modules areat a difficult angle with another. In other words, the outer housing10072 is shaped and/or sized to guide the electrical connection elements10076 of the bridge connector 10070 into a properly aligned engagementwith the bridge connector 10074, thereby establishing electrical and/orsignal communication between the modules and/or alignment between themodules. Further, an outer housing 10078 of the bridge connector 10074can be shaped and/or sized to guide the electrical connection elementsof the bridge connector 10074 into a properly aligned engagement withthe bridge connector 10070, thereby establishing electrical and/orsignal communication between the modules and/or alignment between themodules. The bridge connectors, 10070 and 10074, illustrated in FIGS.55-57 can facilitate alignment of the respective electrical connectionelements regardless of the angle that male and female portions of theconnectors initially mate. Therefore, the modular energy system can bemore rapidly assembled into a stacked configuration and the electricalconnections therebetween can be more reliable.

As stated herein, the modules of a modular energy system can beconnected via bridge connectors and, due to the weight of the modules, auser may find it difficult to keep the modules level during stacking. Incertain instances, the user may pay more attention to the mechanicalassembly of the modules (e.g., leveling) and less attention to theelectrical connections between the modules. Thus, the electricalconnection can be improper and/or damaged during stacking of themodules. Separating the mechanical assembly from the electrical assemblyof the modules can facilitate faster assembly of the modular energysystem and/or increase the reliability of electrical connections betweenmodules in the modular energy system.

Referring now to FIGS. 58 and 59 , a configuration is shown in whichthree surgical modules, a first module 10082, a second module 10084, anda third module 10086, are assembled together in a stacked configurationby an end user utilizing a park and hide module connection to facilitatethe transmission of communication signals and power between modules.Each module, 10082, 10084, and 10086, can be the same type of surgicalmodule or different types of surgical modules. For example, each module10082, 10084, 10086, can be a header module, an energy module, agenerator module, an imaging module, a smoke evacuation module, asuction/irrigation module, a communication module, a processor module, astorage array, a surgical device coupled to a display, a non-contactsensor module, or other modular device. These and other such modules aredescribed above under the headings SURGICAL HUBS and MODULAR ENERGYSYSTEM.

Each module, 10082, 10084, and 10086, can include a park and hide bridgeconnector. For example, the first module 10082 can comprise an upperbridge connector 10088 and a park and hide bridge connector 10090, thesecond module 10084 can comprise an upper bridge connector 10092 and apark and hide bridge connector 10094, and the third module 10086 cancomprise an upper bridge connector. The bridge connectors, 10088, 10090,10092, and 10094, are positioned on a surface of the respective module,10082, 10084, 10086, which may not engage and/or face another modulewhen assembled together in a stacked configuration. In other words, thebridge connectors, 10088, 10090, 10092, and 10094, can be accessible andbe manipulated to establish or to de-establish electrical connectionswhen the modules, 10082, 10084, and 10086, are in the stackedconfiguration.

The connectors, 10090 and 10094, can comprise three positions, a hideposition, an extended position, and an engaged position. As illustratedin FIG. 58 , the connector 10090 is in an extended position and can bemoved into the hide position by translating the connector 10090 in thedirection 10098. Thus, the connector 10090 can be hidden within theenclosure 10100 of the first module 10082 such that the connector 10090can be protected from damage during and/or inhibited from interferingwith stacking of the modular energy system 10080.

After stacking of the modular energy system 10080, the connector 10090can be moved from the hide position, into the extended position asillustrated in FIG. 58 , and thereafter into the engaged position byrotating the connector 10090 in the direction 10102. For example, theconnector 10094 of the second module 10084 has been rotated into theengaged position and operably coupled to the upper bridge connector ofthe third module 10086, thereby establishing electrical and/or signalcommunication between the second module 10084 and the third module10086. Separating the mechanical assembly from the electrical assemblyof the modules utilizing a park and hide bridge connector can enable theuser to more reliably establish the electrical connection and inhibitaccidental damage of a connector.

Additionally, the connector 10090 can include an opening 10104configured to enable access to the upper bridge connector 10088 whilethe connector 10090 is in the engaged position. Thus, referring to FIG.59 , an additional module 10106 can be added to the first three modules,10082, 10084, and 10086, of the modular energy system 10080 by restingthe additional module 10106 first on top of the first module 10082 andsliding the additional module 10106 across the top surface of firstmodule 10092, in the direction indicated by the arrow 10108, until theadditional module 10106 and the first module 10082 are assembled intothe stacked configuration and/or aligned. Thereafter, a park and hideconnector 10110 of the additional module 10106 can be rotated from theextended position as illustrated in FIG. 59 into the engaged position(not shown), thereby establishing electrical and/or signal communicationbetween the first module 10082 and the additional module 10106.

Referring now to FIGS. 60 and 61 , a configuration is shown in which twosurgical modules, a first module 10112 and a second module 10114, areassembled together in a stacked configuration by an end user utilizing ajumper cable to facilitate the transmission of communication signals andpower between modules. Each module, 10112 and 10114, can be the sametype of surgical module or different types of surgical modules. Forexample, each module, 10112 and 10114, can be a header module, an energymodule, a generator module, an imaging module, a smoke evacuationmodule, a suction/irrigation module, a communication module, a processormodule, a storage array, a surgical device coupled to a display, anon-contact sensor module, or other modular device. These and other suchmodules are described above under the headings SURGICAL HUBS and MODULARENERGY SYSTEM.

Each module, 10112 and 10114, can include a bridge connector. Forexample, the first module 10112 can comprise a bridge connector 10116and the second module 10114 can comprise a bridge connector 10118. Thebridge connectors, 10016 and 10018, are positioned on a surface of therespective module 10112 and 10114, which may not engage and/or faceanother module when assembled together in a stacked configuration. Forexample, as illustrated in FIG. 60 , the bridge connector 10116 isprotruding from a back surface 10120 a of the enclosure 10120 of thefirst module 10112 and the bridge connector 10118 is protruding from aback surface 10122 a of an enclosure 10122 of the second module 10114.In other words, the bridge connectors, 10116 and 10118, can beaccessible and manipulated to establish or to de-establish electricalconnections between modules when in the stacked configuration.

The bridge connector 10116 and 10118 can be a male blade connector. Ajumper cable 10124 can be operably coupled to the bridge connectors,10116 and 10118, thereby establishing electrical and/or signalcommunication between the first module 10112 and the second module10114. The jumper cable 10124 can comprise two ends, 10126 and 10128,and wires 10130 extending therebetween. In one aspect, each end, 10126and 10128, is a female blade connector. The ends, 10126 and 10128, ofthe jumper cable 10124 can be configured to respectively engage thebridge connectors, 10016 and 10018, of the modules, 10112 and 10114, toelectrically and/or communicatively couple the modules, 10112 and 10114.

Referring to FIG. 69 , the jumper cable 10124 is connected to the bridgeconnector 10116 of the first module 10112. The bridge connector 10116can comprise electrical elements 10136, which are electrically connectedto wires 10132, and the wires 10132 can be electrically connected to aPCB (not shown) within the first module 10112 by any suitable number ofconnections.

Securing the modules together in the stacked configuration can preventmodules assembled in the stacked configuration from becoming misalignedwhile adding an additional module. Thus, various latches and latchingmechanisms are provided to secure modules to one another.

For example, the first module 10112 can be stacked on top of the secondmodule 10114 as illustrated in FIGS. 60 and 61 . To secure the modules,10112 and 10114, together, a flip-down latch 10142 of the first module10112 can be rotated along direction 10144 from a first position asillustrated in FIG. 60 to a second position as illustrated in FIG. 61 .The flip-down latch 10142 can engage a joining portion 10146 of thesecond module 10114, thereby establishing a mechanical connectionbetween the modules, 10112 and 10114. The joining portion 10146 can be,for example, a recessed portion on the enclosure 10122 a of the secondmodule 10114. The joining portion 10146 can have features configured toengage and mate with the flip-down latch 10142. In various aspects, themodules, 10112 and 10114, can comprise two or more flip down latches.

Referring to FIG. 62 , a configuration is shown in which three modules,a first module 10148, a second module 10150, and a third module 10152,are assembled together in a stacked configuration by an end user.Thereafter, a cord assembly 10154 of the second module 10150 can beconfigured to engage a joining portion 10156 of the third module 10152,thereby mechanically connecting the modules, 10150 and 10152, togetheras illustrated in FIG. 62 . In some examples, the cord assembly 10154can also establish electrical and/or signal communication between thesecond module 10150 and the third module 10152. Similarly, a leverassembly 10158 of the first module 10148 can be configured to engage ajoining portion 10160 of the second module 10150, thereby mechanicallyconnecting the modules, 10148 and 10150, together. The lever assembly10158 can also establish electrical and/or signal communication betweenthe first module 10148 and the second module 10150. Accordingly, amodular energy system can comprise various latches and latchingmechanisms that are the same or that are different as illustrated inFIG. 62 .

Referring to FIGS. 63A and 63B, a configuration is shown in which themodules of a modular energy system can comprise a flip-down latch. Forexample, two modules, a first module 10162 and a second module 10164,are assembled together in a stacked configuration by an end user. Thefirst module 10162 is connected to the second module 10164 by aflip-down latch 10166. Thereafter, an additional module 10168 can bestacked on top of the first module 10162 and secured to the first module10162 by a flip-down latch 10170.

Referring to FIGS. 64A, 64B, 65, and 66 , a configuration is shown inwhich the modules of a modular energy system can comprise a rotatablelatch assembly configured to secure the modules together in the stackedconfiguration. In one aspect, as illustrated in FIGS. 64A and 64B, threemodules, a first module 10246, a second module 10248, and a third module10250, are assembled together in a stacked configuration by an end user.The first module 10246 comprises rotatable latch assemblies 10238, thesecond module 10248 comprises rotatable latch assemblies 10240, and thethird module 10250 comprises rotatable latch assemblies 10242. The firstmodule 10246 is connected to the second module 10248 by the rotatablelatch assemblies 10240. The second module 10248 is connected to thethird module 10250 by the rotatable latch assemblies 10242.

Each rotatable latch assembly, 10238, 10240, and 10242, comprises ahandle and a hook assembly. For example, referring to FIG. 64B,rotatable latch assembly 10238 comprises handle 10238 a and hookassembly 10240 b. The handle 10238 a can be rotated from a disengagedposition where the hook assembly 10238 b is positioned within theenclosure 10244 of the first module 10246 to an engaged positioned wherethe hook assembly 10238 b protrudes from a top surface 10244 a of theenclosure 10244 and is configured to engage a joining portion of anenclosure of a separate module. Thus, an upper module and a lower modulecan be secured together in a stacked configured when the rotatable latchassemblies of the lower module are configured in the engaged position.The upper and lower modules can be disassembled from a stackedconfiguration when the rotatable latch assemblies of the lower moduleare configured in the disengaged position.

In one aspect, as illustrated in FIG. 65 , three modules, a first module10172, a second module 10174, and a third module 10176, are assembledtogether in a stacked configuration by an end user. The first modulecomprises rotatable latch assembly 10178, the second module comprisesrotatable latch assembly 10180, and the third module comprises rotatablelatch assemblies 10182. The first module 10172 is connected to thesecond module 10174 by the rotatable latch assembly 10180. The secondmodule 10174 is connected to the third module 10176 by the rotatablelatch assembly 10182.

Each rotatable latch assembly, 10178, 10180, and 10182, comprises ahandle and a hook assembly. For example, the rotatable latch assembly10178 comprises a handle 10178 a and a hook assembly 10178 b. The handle10178 a can be rotated from a disengaged position where the hookassembly 10178 b is positioned within the enclosure 10184 of the firstmodule 10172 to an engaged positioned where the hook assembly 10178 bprotrudes from a top surface 10184 a of the enclosure 10184 and isconfigured to engage a joining portion of an enclosure of a separatemodule. Thus, an upper module and a lower module can be secured togetherin a stacked configured when the rotatable latch assembly of the lowermodule is configured in the engaged position. The upper and lowermodules can be disassembled from a stacked configuration when therotatable latch assembly of the lower module is configured in thedisengaged position.

Referring to FIG. 66 , a configuration is shown in which three modules,a first module 10186, a second module 10188, and a third module 10190,are assembled together in a stacked configuration by an end user. Thefirst module 10186 comprises a first latch assembly 10192 and a secondlatch assembly 10194. Upon moving the handle 10192 a of the first latchassembly 10192 in the direction 10196, a hook assembly 10198 of thefirst latch assembly moves in the direction 10200 and engages theenclosure 10202 of the second module 10188, thereby mechanicallysecuring the first module 10186 to the second module 10188. The secondlatch assembly 10194 operates in a similar manner to the first latchassembly 10192.

Similarly, the second module 10188 comprises a first latch assembly10204 and a second latch assembly 10206. The latch assemblies, 10204 and10206, can engage the enclosure 10208 of the third module 10190, therebymechanically securing the second module 10188 to the third module 10190.

Referring to FIG. 67 , a configuration is shown in which two modules, afirst module 10210 and a second module 10212, are assembled together ina stacked configuration by an end user. The first module 10210 comprisesa cord assembly 10214, which can be configured to engage with acorresponding connector or portion of another module (such as the secondmodule 10212). Accordingly, the cord assembly 10214 can be transitionbetween a first position 10216, in which the core assembly 10214 can besecured to the first module 10210 (and thus disengaged from the secondmodule 10212), and a second position 10218. Upon configuring the cordassembly 10214 in the second position 10218, the first module 10210 canbe mechanically secured to the second module 10212 by the cord assembly10214. In one aspect, the cord assembly 10214 can also establishelectrical and/or signal communication between the first module 10210and the second module 10212. That is, the cord assembly 10214 can beattached to a PCB of the first module 10210 and connected to a bridgeconnector of the second module 10212. However, the cord assembly 10212can be sized and configured to maintain the position of the first module10210 with respect to the second module 10212.

Referring to FIG. 68 , two modules, a first module 10220 and a secondmodule 10222, are assembled together in a stacked configuration by anend user. The first module 10220 comprises a recess 10224 configured toreceive a plug 10226 and the second module 10222 comprises a recess10228 that is also configured to receive the plug 10226. The plug 10226can be slidably disposed within or slidably connected to either therecess 10224 of the first module 10220 or the recess 10228 of the secondmodule 10222. The plug 10226 can be moveable between a first positionand a second position. In one aspect, in the first position, the plug10226 can be solely within the recess 10228 of the second module 10222.The plug 10226 can be translated in the direction 10230 and into therecess 10226 in order to mechanically secure the first module 10220 andthe second module 10222. In an alternative aspect, in the firstposition, the plug 10226 can be positioned within the recess 10224 ofthe first module 10220 and then translated to engage the correspondingrecess 10228 of the second module 10222 to mechanically engage the firstand second modules 10220, 10222 together.

In various aspects, the plug 10226 is electrically connected to a wireharness 10140 and comprises first electrical connection elements on anend 10236 of the plug 10226. The recess 10226 can comprise a bridgeconnector portion 10234 comprising second electrical connectionelements. The plug 10226 can be translated in direction 10230 and cancontact the second electrical connection elements, thereby establishingelectrical and/or signal communication between the first module 10220and the second module 10222.

In various aspects, the bridge connector can be electrically coupled toa flexible power supply (e.g., an H-bridge type power supply) that isconfigured to provide current and voltage feedback and control. Theflexible power supply can be configured to a variety of differentapplications, including fixed pulsing power delivery, pulse-widthmodulation (PWM) pulsing power delivery, closed-loop control (i.e.,based upon feedback provided to the power supply), delivery of AC and/orDC power, power mitigation (e.g., as is described in U.S. patentapplication Ser. No. 16/562,203, titled POWER AND COMMUNICATIONMITIGATION ARRANGEMENT FOR MODULAR SURGICAL ENERGY SYSTEM, filed on Sep.5, 2019, which is hereby incorporated by reference herein), and/orseparate patient isolation of hardware. These and other functions can beenabled for any module coupled to the flexible power supply through theconnections between the opposing bridge connectors as the modules areengaged together.

EXAMPLES

Various aspects of the subject matter described herein are set out inthe following numbered examples:

Example 1. A method for controlling an output of an energy module of amodular energy system, the energy module comprising a plurality ofamplifiers and a plurality of ports coupled to the plurality ofamplifiers, each of the plurality of amplifiers configured to generate adrive signal at a frequency range, each of the plurality of portsconfigured to drive an energy modality for a surgical instrumentconnected thereto according to each drive signal, the method comprising:determining to which port of the plurality of ports the surgicalinstrument is connected; selectively coupling an amplifier of theplurality of amplifiers to the port of the plurality of ports to whichthe surgical instrument is connected; and controlling the amplifier todeliver the drive signal for driving the energy modality to the surgicalinstrument through the port.

Example 2. The method of Example 1, wherein the energy modalitycomprises monopolar electrosurgical energy.

Example 3. The method of Example 2, wherein: the port comprises a firstport; and the plurality of ports further comprises a second port coupledto the amplifier, the second port configured to be connected to amonopolar return pad configured to serve as an electrical ground for themonopolar electrosurgical energy.

Example 4. The method of Example 3, wherein the energy module furthercomprises an isolation transformer coupling the first port and thesecond port to the amplifier.

Example 5. The method of any one of Examples 1-4, wherein: the surgicalinstrument comprises a first surgical instrument; the port comprises afirst port; and the plurality of ports further comprises a second portcoupled to the amplifier, the second port configured to be connected toa second surgical instrument.

Example 6. The method of Example 5, further comprising: determiningwhether a fault condition is occurring where the drive signal is beingdelivered to the second port; and in the fault condition, deactivatingthe amplifier.

Example 7. A method for controlling an output of an energy module of amodular energy system, the energy module comprising a plurality ofamplifiers, a plurality of ports coupled to the plurality of amplifiers,and a relay assembly, each of the plurality of amplifiers configured togenerate a drive signal at a frequency range, each of the plurality ofports configured to drive an energy modality for a surgical instrumentconnected thereto according to each drive signal, the method comprising:controlling a first amplifier of the plurality of amplifiers to delivera first drive signal to the surgical instrument connected to a port;controlling the relay assembly to couple a second amplifier of theplurality of amplifiers to the port; and controlling the secondamplifier to deliver a second drive signal to the surgical instrumentconnected to the port.

Example 8. The method of Example 7, wherein the second drive signal isconfigured to drive monopolar electrosurgical energy deliverable by thesurgical instrument.

Example 9. The method of Example 8, wherein: the port comprises a firstport; and the plurality of ports further comprises a second port coupledto the amplifier, the second port configured to be connected to amonopolar return pad configured to serve as an electrical ground for themonopolar electrosurgical energy.

Example 10. The method of Example 9, wherein the energy module furthercomprises an isolation transformer coupling the first port and thesecond port to the amplifier.

Example 11. The method of any one of Examples 7-10, wherein: thesurgical instrument comprises a first surgical instrument; the portcomprises a first port; and the plurality of ports further comprises asecond port selectively couplable to the amplifier via the relayassembly, the second port configured to be connected to a secondsurgical instrument.

Example 12. The method of Example 11, further comprising: determiningwhether a fault condition is occurring where the drive signal is beingdelivered to the second port; and in the fault condition, deactivatingthe amplifier.

While several forms have been illustrated and described, it is not theintention of Applicant to restrict or limit the scope of the appendedclaims to such detail. Numerous modifications, variations, changes,substitutions, combinations, and equivalents to those forms may beimplemented and will occur to those skilled in the art without departingfrom the scope of the present disclosure. Moreover, the structure ofeach element associated with the described forms can be alternativelydescribed as a means for providing the function performed by theelement. Also, where materials are disclosed for certain components,other materials may be used. It is therefore to be understood that theforegoing description and the appended claims are intended to cover allsuch modifications, combinations, and variations as falling within thescope of the disclosed forms. The appended claims are intended to coverall such modifications, variations, changes, substitutions,modifications, and equivalents.

The foregoing detailed description has set forth various forms of thedevices and/or processes via the use of block diagrams, flowcharts,and/or examples. Insofar as such block diagrams, flowcharts, and/orexamples contain one or more functions and/or operations, it will beunderstood by those within the art that each function and/or operationwithin such block diagrams, flowcharts, and/or examples can beimplemented, individually and/or collectively, by a wide range ofhardware, software, firmware, or virtually any combination thereof.Those skilled in the art will recognize that some aspects of the formsdisclosed herein, in whole or in part, can be equivalently implementedin integrated circuits, as one or more computer programs running on oneor more computers (e.g., as one or more programs running on one or morecomputer systems), as one or more programs running on one or moreprocessors (e.g., as one or more programs running on one or moremicroprocessors), as firmware, or as virtually any combination thereof,and that designing the circuitry and/or writing the code for thesoftware and or firmware would be well within the skill of one of skillin the art in light of this disclosure. In addition, those skilled inthe art will appreciate that the mechanisms of the subject matterdescribed herein are capable of being distributed as one or more programproducts in a variety of forms, and that an illustrative form of thesubject matter described herein applies regardless of the particulartype of signal bearing medium used to actually carry out thedistribution.

Instructions used to program logic to perform various disclosed aspectscan be stored within a memory in the system, such as dynamic randomaccess memory (DRAM), cache, flash memory, or other storage.Furthermore, the instructions can be distributed via a network or by wayof other computer readable media. Thus a machine-readable medium mayinclude any mechanism for storing or transmitting information in a formreadable by a machine (e.g., a computer), but is not limited to, floppydiskettes, optical disks, compact disc, read-only memory (CD-ROMs), andmagneto-optical disks, read-only memory (ROMs), random access memory(RAM), erasable programmable read-only memory (EPROM), electricallyerasable programmable read-only memory (EEPROM), magnetic or opticalcards, flash memory, or a tangible, machine-readable storage used in thetransmission of information over the Internet via electrical, optical,acoustical or other forms of propagated signals (e.g., carrier waves,infrared signals, digital signals, etc.). Accordingly, thenon-transitory computer-readable medium includes any type of tangiblemachine-readable medium suitable for storing or transmitting electronicinstructions or information in a form readable by a machine (e.g., acomputer).

As used in any aspect herein, the term “control circuit” may refer to,for example, hardwired circuitry, programmable circuitry (e.g., acomputer processor including one or more individual instructionprocessing cores, processing unit, processor, microcontroller,microcontroller unit, controller, digital signal processor (DSP),programmable logic device (PLD), programmable logic array (PLA), orfield programmable gate array (FPGA)), state machine circuitry, firmwarethat stores instructions executed by programmable circuitry, and anycombination thereof. The control circuit may, collectively orindividually, be embodied as circuitry that forms part of a largersystem, for example, an integrated circuit (IC), an application-specificintegrated circuit (ASIC), a system on-chip (SoC), desktop computers,laptop computers, tablet computers, servers, smart phones, etc.Accordingly, as used herein “control circuit” includes, but is notlimited to, electrical circuitry having at least one discrete electricalcircuit, electrical circuitry having at least one integrated circuit,electrical circuitry having at least one application specific integratedcircuit, electrical circuitry forming a general purpose computing deviceconfigured by a computer program (e.g., a general purpose computerconfigured by a computer program which at least partially carries outprocesses and/or devices described herein, or a microprocessorconfigured by a computer program which at least partially carries outprocesses and/or devices described herein), electrical circuitry forminga memory device (e.g., forms of random access memory), and/or electricalcircuitry forming a communications device (e.g., a modem, communicationsswitch, or optical-electrical equipment). Those having skill in the artwill recognize that the subject matter described herein may beimplemented in an analog or digital fashion or some combination thereof.

As used in any aspect herein, the term “logic” may refer to an app,software, firmware and/or circuitry configured to perform any of theaforementioned operations. Software may be embodied as a softwarepackage, code, instructions, instruction sets and/or data recorded onnon-transitory computer readable storage medium. Firmware may beembodied as code, instructions or instruction sets and/or data that arehard-coded (e.g., nonvolatile) in memory devices.

As used in any aspect herein, the terms “component,” “system,” “module”and the like can refer to a computer-related entity, either hardware, acombination of hardware and software, software, or software inexecution.

As used in any aspect herein, an “algorithm” refers to a self-consistentsequence of steps leading to a desired result, where a “step” refers toa manipulation of physical quantities and/or logic states which may,though need not necessarily, take the form of electrical or magneticsignals capable of being stored, transferred, combined, compared, andotherwise manipulated. It is common usage to refer to these signals asbits, values, elements, symbols, characters, terms, numbers, or thelike. These and similar terms may be associated with the appropriatephysical quantities and are merely convenient labels applied to thesequantities and/or states.

A network may include a packet switched network. The communicationdevices may be capable of communicating with each other using a selectedpacket switched network communications protocol. One examplecommunications protocol may include an Ethernet communications protocolwhich may be capable permitting communication using a TransmissionControl Protocol/Internet Protocol (TCP/IP). The Ethernet protocol maycomply or be compatible with the Ethernet standard published by theInstitute of Electrical and Electronics Engineers (IEEE) titled “IEEE802.3 Standard”, published in December, 2008 and/or later versions ofthis standard. Alternatively or additionally, the communication devicesmay be capable of communicating with each other using an X.25communications protocol. The X.25 communications protocol may comply orbe compatible with a standard promulgated by the InternationalTelecommunication Union-Telecommunication Standardization Sector(ITU-T). Alternatively or additionally, the communication devices may becapable of communicating with each other using a frame relaycommunications protocol. The frame relay communications protocol maycomply or be compatible with a standard promulgated by ConsultativeCommittee for International Telegraph and Telephone (CCITT) and/or theAmerican National Standards Institute (ANSI). Alternatively oradditionally, the transceivers may be capable of communicating with eachother using an Asynchronous Transfer Mode (ATM) communications protocol.The ATM communications protocol may comply or be compatible with an ATMstandard published by the ATM Forum titled “ATM-MPLS NetworkInterworking 2.0” published August 2001, and/or later versions of thisstandard. Of course, different and/or after-developedconnection-oriented network communication protocols are equallycontemplated herein.

Unless specifically stated otherwise as apparent from the foregoingdisclosure, it is appreciated that, throughout the foregoing disclosure,discussions using terms such as “processing,” “computing,”“calculating,” “determining,” “displaying,” or the like, refer to theaction and processes of a computer system, or similar electroniccomputing device, that manipulates and transforms data represented asphysical (electronic) quantities within the computer system's registersand memories into other data similarly represented as physicalquantities within the computer system memories or registers or othersuch information storage, transmission or display devices.

One or more components may be referred to herein as “configured to,”“configurable to,” “operable/operative to,” “adapted/adaptable,” “ableto,” “conformable/conformed to,” etc. Those skilled in the art willrecognize that “configured to” can generally encompass active-statecomponents and/or inactive-state components and/or standby-statecomponents, unless context requires otherwise.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Those skilled in the art will recognize that, in general, terms usedherein, and especially in the appended claims (e.g., bodies of theappended claims) are generally intended as “open” terms (e.g., the term“including” should be interpreted as “including but not limited to,” theterm “having” should be interpreted as “having at least,” the term“includes” should be interpreted as “includes but is not limited to,”etc.). It will be further understood by those within the art that if aspecific number of an introduced claim recitation is intended, such anintent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to claims containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (e.g., “a” and/or “an” should typically be interpreted to mean “atleast one” or “one or more”); the same holds true for the use ofdefinite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitationis explicitly recited, those skilled in the art will recognize that suchrecitation should typically be interpreted to mean at least the recitednumber (e.g., the bare recitation of “two recitations,” without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to “at least one of A, B, and C, etc.” is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., “a system having at least one ofA, B, and C” would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to “at least one of A, B, or C, etc.” is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., “a system having at leastone of A, B, or C” would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that typically a disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms unless context dictates otherwise. For example, the phrase “Aor B” will be typically understood to include the possibilities of “A”or “B” or “A and B.”

With respect to the appended claims, those skilled in the art willappreciate that recited operations therein may generally be performed inany order. Also, although various operational flow diagrams arepresented in a sequence(s), it should be understood that the variousoperations may be performed in other orders than those which areillustrated, or may be performed concurrently. Examples of suchalternate orderings may include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Furthermore, terms like “responsive to,” “related to,” or otherpast-tense adjectives are generally not intended to exclude suchvariants, unless context dictates otherwise.

It is worthy to note that any reference to “one aspect,” “an aspect,”“an exemplification,” “one exemplification,” and the like means that aparticular feature, structure, or characteristic described in connectionwith the aspect is included in at least one aspect. Thus, appearances ofthe phrases “in one aspect,” “in an aspect,” “in an exemplification,”and “in one exemplification” in various places throughout thespecification are not necessarily all referring to the same aspect.Furthermore, the particular features, structures or characteristics maybe combined in any suitable manner in one or more aspects.

Any patent application, patent, non-patent publication, or otherdisclosure material referred to in this specification and/or listed inany Application Data Sheet is incorporated by reference herein, to theextent that the incorporated materials is not inconsistent herewith. Assuch, and to the extent necessary, the disclosure as explicitly setforth herein supersedes any conflicting material incorporated herein byreference. Any material, or portion thereof, that is said to beincorporated by reference herein, but which conflicts with existingdefinitions, statements, or other disclosure material set forth hereinwill only be incorporated to the extent that no conflict arises betweenthat incorporated material and the existing disclosure material.

In summary, numerous benefits have been described which result fromemploying the concepts described herein. The foregoing description ofthe one or more forms has been presented for purposes of illustrationand description. It is not intended to be exhaustive or limiting to theprecise form disclosed. Modifications or variations are possible inlight of the above teachings. The one or more forms were chosen anddescribed in order to illustrate principles and practical application tothereby enable one of ordinary skill in the art to utilize the variousforms and with various modifications as are suited to the particular usecontemplated. It is intended that the claims submitted herewith definethe overall scope.

1-12. (canceled)
 13. An energy module comprising: an amplifier to generate a drive signal at a frequency range; a plurality of ports comprising: a first port; a second port; and a third port; a selection relay coupled to the plurality of ports and the amplifier and comprising a plurality of outputs, the selection relay comprising: a first relay to selectively couple the amplifier to the first port; a second relay to selectively couple the amplifier to the second port; and a third relay to selectively couple the amplifier to the third port; wherein the selection relay is to receive the drive signal from the amplifier and to output the drive signal through one of the first, second, or third relays to the corresponding first, second, or third port, wherein each of the plurality of ports is to drive an energy modality according to each drive signal; and a control circuit coupled to the amplifier and the selection relay, the control circuit is to: set the drive signal of the amplifier; and selectively couple one of the relays of the selection relay to the corresponding port.
 14. The energy module of claim 13, wherein the first port is a combination energy port to output different energy modalities to a surgical instrument.
 15. The energy module of claim 14, wherein the combination energy port comprises a bipolar energy mode, a monopolar energy mode, and an ultrasonic energy mode.
 16. The energy module of claim 13, wherein the second port is a bipolar energy port to output bipolar RF energy to a surgical instrument.
 17. The energy module of claim 13, wherein the third port is a monopolar energy port to output monopolar RF energy to a surgical instrument.
 18. The energy module of claim 13, each of the plurality of ports couples to the control circuit to provide a feedback signal to the control circuit.
 19. The energy module of claim 13, wherein the amplifier is a wideband RF power amplifier.
 20. The energy module of claim 13, wherein the control circuit is to determine a surgical instrument is connected to one of the plurality of ports.
 21. An energy module comprising: an amplifier to generate a drive signal at a frequency range; a plurality of ports comprising: a first port; a second port; and a third port; a selection relay coupled to the plurality of ports and the amplifier and comprising a plurality of outputs, the selection relay comprising: a first relay to selectively couple the amplifier to the first port; a second relay to selectively couple the amplifier to the second port; and a third relay to selectively couple the amplifier to the third port; wherein the selection relay is to receive the drive signal from the amplifier and to output the drive signal through one of the first, second, or third relays to the corresponding first, second, or third port, wherein each of the plurality of ports is to drive an energy modality according to each drive signal; and a control circuit coupled to the amplifier and the selection relay, the control circuit is to: set the drive signal of the amplifier; and switch between a plurality of states of the selection relay.
 22. The energy module of claim 21, wherein in a first state, the control circuit selectively couples the amplifier to the first port to transmit the drive signal of the amplifier to the first port.
 23. The energy module of claim 21, wherein in a second state, the control circuit selectively couples the amplifier to the second port to transmit the drive signal of the amplifier to the second port.
 24. The energy module of claim 21, wherein in a third state, the control circuit selectively couples the amplifier to the third port to transmit the drive signal of the amplifier to the third port.
 25. The energy module of claim 21, wherein the first port is a combination energy port to output different energy modalities to a surgical instrument.
 26. The energy module of claim 25, wherein the combination energy port comprises a bipolar energy mode, a monopolar energy mode, and an ultrasonic energy mode.
 27. The energy module of claim 21, wherein the second port is a bipolar energy port to output bipolar RF energy to a surgical instrument.
 28. The energy module of claim 21, wherein the third port is a monopolar energy port to output monopolar RF energy to a surgical instrument.
 29. The energy module of claim 21, each of the plurality of ports couples to the control circuit to provide a feedback signal to the control circuit.
 30. The energy module of claim 21, wherein the amplifier is a wideband RF power amplifier.
 31. The energy module of claim 21, wherein the control circuit is to determine a surgical instrument is connected to one of the plurality of ports.
 32. The energy module of claim 21, wherein each of the plurality of ports comprises a leakage current detection circuit. 